Journal ArticleDOI
Steroid-specific and anticonvulsant interaction aspects of troleandomycin-steroid therapy
Stanley J. Szefler,Stanley J. Szefler,Elliot F. Ellis,Elliot F. Ellis,Manon Brenner,Manon Brenner,James Q. Rose,James Q. Rose,Sheldon L. Spector,Sheldon L. Spector,Anthony M. Yurchak,Anthony M. Yurchak,Francine Andrews,Francine Andrews,William J. Jusko,William J. Jusko +15 more
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TLDR
The effect of TAO on corticosteroid disposition is steroid-specific and TAO can diminish the effect of certain drugs on the induction of corticosterone metabolism, possibly contributing to its beneficial effects.Abstract:
Troleandomycin (TAO) is a macrolide antibiotic that has an apparent "steroid-sparing" effect when used in the treatment of severe steroid-dependent asthmatic patients. Recent observations demonstrated the effect of TAO on inhibiting methylprednisolone elimination, possibly contributing to its beneficial effects. Prednisolone and methylprednisolone disposition were studied before and 1 wk after initiation of TAO therapy in three patients. Methylprednisolone elimination was characteristically impaired in the presence of TAO therapy; however, there was no apparent effect on prednisolone elimination. Methylprednisolone elimination was also evaluated before and after initiation of TAO therapy in three patients receiving concomitant anticonvulsant therapy with phenobarbital-1, phenytoin-2. Methylprednisolone clearance before TAO was at least 4 times faster than normal and was probably related to enzyme induction by the anticonvulsant medication. Methylprednisolone clearance was subsequently reduced by approximately 70% in the presence of TAO therapy. The effect of TAO on corticosteroid disposition is steroid-specific and TAO can diminish the effect of certain drugs on the induction of corticosteroid metabolism.read more
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Journal ArticleDOI
Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data
J. A. P. Da Silva,J. W. G. Jacobs,John R. Kirwan,Maarten Boers,Kenneth G. Saag,Luís Inês,E J P de Koning,Frank Buttgereit,Maurizio Cutolo,H Capell,Rolf Rau,Johannes W. J. Bijlsma +11 more
TL;DR: Safety data from recent randomised controlled clinical trials of low dose glucocorticoid treatment in RA suggest that adverse effects associated with this drug are modest, and often not statistically different from those of placebo.
Journal ArticleDOI
Pharmacokinetic Drug Interactions of Macrolides
TL;DR: These incriminated macrolide antibiotics should not be administered concomitantly with other drugs known to be affected metabolically by them, or at the very least, combined administration should be carried out only with careful patient monitoring.
Journal ArticleDOI
Drug metabolism by cytochromes P450 in the liver and small bowel.
TL;DR: Mounting evidence shows that many of the clinically relevant aspects of P450s that have been ascribed to the liver may in fact be occurring at the level of the intestinal mucosa, in which enterocyte metabolism appears largely to account for drug interactions and differences among patients in dosing requirements.
Journal ArticleDOI
Macrolide antibacterials. Drug interactions of clinical significance.
N A von Rosensteil,D Adam +1 more
TL;DR: Macrolide antibiotics can interact adversely with commonly used drugs, usually by altering metabolism due to complex formation and inhibition of cytochrome P-450 IIIA4 in the liver and enterocytes, and through enhanced gastric emptying due to a motilin-like effect.
Journal ArticleDOI
Macrolides for chronic asthma
Kayleigh M Kew,Krishna Undela,Ioanna Kotortsi,Giovanni Ferrara,Giovanni Ferrara,Giovanni Ferrara +5 more
TL;DR: Macrolides were not found to be better than placebo for the majority of clinical outcomes including exacerbations requiring hospital admission, and two studies recruiting people taking regular oral corticosteroids suggested macrolides may have a steroid-sparing effect in this population.
References
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Journal ArticleDOI
A comparison of numerical integrating algorithms by trapezoidal, Lagrange, and spline approximation
K. C. Yeh,K.C. Kwan +1 more
TL;DR: Two alternative algorithms based on known interpolating functions have been implemented for area calculations in the Lagrange method and the spline method and are described with numerical examples.
Journal ArticleDOI
Inhibition of theophylline clearance by troleandomycin.
TL;DR: It is suggested that possibility of inducing theophylline toxicity, including seizures, as was observed in one of the patients in this study, may be at least a partial explanation for the apparent benefit of troleandomycin in chronic asthma.
Journal ArticleDOI
Adverse Effects of Phenobarbital on Corticosteroid Metabolism in Patients with Bronchial Asthma
TL;DR: The effects of phenobarbital therapy on plasma kinetics of labeled dexamethasone were investigated in 11 asthmatic patients as mentioned in this paper, who showed a mean decrease in half-life of 117 minutes and an increase in metabolic clearance rate of 272 liters per day (+88 per cent).
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