Purpose: The aim of the study was to develop a proniosomal carrier system for captopril for the treatment of hypertension that is capable of efficiently delivering entrapped drug over an extended period of time. Method: The potential of proniosomes as a transdermal drug delivery system for captopril was investigated by encapsulating the drug in various formulations of proniosomal gel composed of various ratios of sorbitan fatty acid esters, cholesterol, lecithin prepared by coacervation-phase separation method. The formulated systems were characterized in vitro for size, vesicle count, drug entrapment, drug release profiles and vesicular stability at different storage conditions. Stability studies for proniosomal gel were carried out for 4 weeks. Results: The method of proniosome loading resulted in an encapsulation yield of 66.7-78.7%. Proniosomes were characterised by transmission electron microscopy. In vitro studies showed prolonged release of entrapped captopril. At refrigerated conditions, higher drug retention was observed. Conclusion: It is evident from this study that proniosomes are a promising prolonged delivery system for captopril and have reasonably good stability characteristics.
The aim of the present study was to design a proniosomal drug delivery system of captopril to overcome the limitations of conventional dosage form and to optimize encapsulation parameters to achieve a delivery system suitable for in vitro investigations. Proniosomes are dry powders, which makes richer processing and packing possible. A surfactant coated carrier method was utilized to formulate proniosomal powder containing captopril as a model drug. This system was evaluated in vitro for drug loading, vesicle size, angle of repose, encapsulation efficiency, and stability studies. This method of proniosome loading resulted in 54.16-70.10% of encapsulation. This study examined critical parameters such as type and composition of surfactant. Proniosomes were investigated by transmission electron microscopy for characterization. Four week stability data for proniosomal powder is reported, and at all sampling points significantly higher drug retention was observed. Thus, it can be concluded that the encapsulation of captopril in proniosomes facilitates the controlled release and constitutes a good choice.
Graves' disease (GD) is associated with various hematologic abnormalities but pancytopenia and autoimmune hemolytic anemia (AIHA) are reported very rarely. Herein, we report a patient with GD who had both of these rare complications at different time intervals, along with a review of the related literature. The patient was a 70-year-old man who, during a hospitalization, was also noted to have pancytopenia and elevated thyroid hormone levels. Complete hematologic workup was unremarkable and his pancytopenia was attributed to hyperthyroidism. He was started on methimazole but unfortunately did not return for followup and stopped methimazole after a few weeks. A year later, he presented with fatigue and weight loss. Labs showed hyperthyroidism and isolated anemia (hemoglobin 7 g/dL). He had positive direct Coombs test and elevated reticulocyte index. He was diagnosed with AIHA and started on glucocorticoids. GD was confirmed with elevated levels of thyroid stimulating immunoglobulins and thyroid uptake and scan. He was treated with methimazole and radioactive iodine ablation. His hemoglobin improved to 10.7 g/dL at discharge without blood transfusion. Graves' disease should be considered in the differential diagnosis of hematologic abnormalities. These abnormalities in the setting of GD generally respond well to antithyroid treatment.
Background: Patients often tell about reduced effectiveness of topical steroids on repeated use. Tachyphylaxis to these agents has been demonstrated in humans for vasoconstriction and histamine-induced wheal suppression in normal skin, but not in diseased skin. Relevance of these data to diseased skin is not clear. Further, the clinical impression does not appear to match tachyphylaxis shown in normal skin with regard to the time course. Objectives: To examine whether tachyphylaxis to histamine-induced wheal suppression by a topical steroid occurs in dermatitic skin and to determine its time course vis-à-vis normal skin. Methods: Pharmacodynamic response to 0.05% clobetasol propionate applied daily under occlusion was measured by histamine-induced wheal suppression assay in 10 individuals. This test was performed on a steroid-treated normal site, on a steroid-treated site where dermatitis was induced by occlusive application of 40% croton oil, and on a vehicle-treated site in each individual at different intervals up to 14 days. Results: Suppression of wheal volume started from second day in steroid-treated sites. There was significant difference in the wheal volume in steroid-treated normal vs. dermatitic sites from day 2 to day 10. Maximum wheal suppression occurred earlier in dermatitic skin (day 4 vs. day 6). After this, the volume of wheal started increasing and became equal to control (complete tolerance) on 12th day in dermatitic skin and on 14th day in normal skin. Conclusions: Time courses of tachyphylaxis to the action of 0.05% clobetasol propionate were significantly different in normal skin and dermatitic skin. Complete tolerance occurred earlier in dermatitic skin compared to normal skin.
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