Background. Indomethacin has been the gold standard for the closure of patent ductus arteriosus (PDA). Still, the availability of the intravenous (IV) form has been a big issue precluding its use in the Philippines. IV ketorolac is another non-steroidal anti-inflammatory drug (NSAID) that is cheaper and more available in our country and used for post-cardiac surgery pain management among neonates.

Objectives. To compare the efficacy of ketorolac versus indomethacin in the closure of patent ductus arteriosus among preterm infants.

Methods. We conducted a randomized controlled, double-blind, crossover design, non-inferiority trial on the use of iindomethacin versus ketorolac among preterm infants with PDA. We enrolled preterm infants at 5-12 days postnatal life, diagnosed with PDA by echocardiography at the Philippine General Hospital (PGH). We excluded infants with upper gastrointestinal bleeding, renal failure, birthweight < 500 grams, septic shock, and lethal anomalies. Patients were randomly allocated between two treatment groups (indomethacin versus ketorolac). The primary outcome measure was PDA closure measured after the treatment course. Adverse events like oliguria and bleeding were recorded.

Results. A total of 27 preterm infants were randomly assigned to the indomethacin (0.2 mg/kg/dose) and ketorolac (0.6 mg/kg/dose) group. Ketorolac has a 60% success rate for PDA closure (9/15) compared to indomethacin 41.67% (5/12) (p=0.154). No renal insufficiency and bleeding diathesis were noted. Five patients died in the study, four in the group initially allocated in ketorolac and one in indomethacin. Causes of death were late-onset sepsis, bronchopulmonary dysplasia, and congenital adrenal hyperplasia.

Conclusion. The success rate of PDA closure between IV ketorolac and IV indomethacin was not significantly different. There was neither oliguria nor bleeding observed in both groups.

No abstract available.
Indomethacin* ; Polyhydramnios*

BACKGROUND: In spite of frequent nasal surgery, the importance of preoperative medication has not been examined carefully(CAREFULLY). OBJECTIVE: To identify the effect of premedication, we investigated the effect of premedication on postoperative pain in nasal surgery under local anesthesia. MATERIALS AND METHOD: We studied 120 cases, composed of 60 cases of unilateral sinus surgery and 60 cases of septoplasty. The patients were divided into four groups. We analysed 4 groups each consisted of 30 patients(N=120). The first group consisted of patients who received atropine preoperatively. The second group received atropine and ketolorac tromethamine. The third group received atopine and diazepam. The fourth group received atropine, ketorolac trimethamine and atropine. To evaluate the postoperative pain, we made the protocol listed according to Verbal Rating Pain Scores(VRP), Visual Analogue Pain Scores(VAS), -2, 4, 6, 12, 24 and 48 hours- and a global postoperative pain using the VAS. RESULTS: In septoplasty group, pain-relief effects showed postoperative pain of ketorolac tromethamine during postoperative 6-hours in the second & fourth groups. In sinus surgery group, Ketorolac tromethamine was effective on postoperative pain at postoperative 2-hour. CONCLUSION: We concluded that preoperative ketorolac tromethamine was effctive on septoplasty group than sinus surgery group.
Anesthesia, Local ; Atropine ; Diazepam ; Humans ; Ketorolac ; Ketorolac Tromethamine ; Nasal Surgical Procedures* ; Pain, Postoperative* ; Premedication* ; Tromethamine

No abstract available.
Ductus Arteriosus* ; Indomethacin*

PURPOSE: The purpose of this study was to observe the effect of IFN- and PGE2 on TNF- production by human peripheral mononuclear cells(PBMC) that were stimulated with LPS. METHODS: PBMC were separated by Ficoll-Hypaque gradient centrifugation from human peripheral venous blood and were incubated for 72 hours with or without LPS, IFN- , PGE2, and indomethacin according to various conditions. TNF- activity of PBMC culture supernatants was assayed by determining the cytotoxicity against L929 cells. RESULTS: 1) The production of TNF- by PBMC in response to LPS reached the highest level between 8-24 hours and returned to control level by 72 hours. 2) When IFN- was added together with LPS, LPS-induced TNF- production was enhanced and prolonged, which was more remarkable when IFN- was added at higher concentration or earlier than LPS. 3) When PGE2 was added together with LPS, LPS-induced TNF- production was suppressed. 4) The addition of IFN-gamma reduced the suppressive effect of PGE2 on LPS-induced TNF- production. 5) Enough amount of indomethacin enhanced production of TNF- by LPS. CONCLUSIONS: IFN-gamma increased and PGE2 decreased the production of TNF- by PBMC which were stimulated with LPS. And PBMC which were pretreated with IFN-gamma were resistent to the suppressive effect of PGE2.
Centrifugation ; Dinoprostone* ; Humans* ; Indomethacin

Optimum formula of indomethacin sustained release pellets prepared by extrusion and spheronization method was obtained by using an artificial neural network. In the pellets, Avicel PH 101 was used as a matrix excipient for sustained release and HPMC E15, PVP K30, polysorbat 80 was used to enhance the solubility of indomethacin from the matrix. The capsules containing prepared indomethacin sustained release pellets showed an in vitro drug release similar to that of CHRONO-INDOCID capsules which were used as a reference product. The studied products were stable during 6 months when preserving in urgent aged condition
Indomethacin ; Pharmaceutical Preparations

The factors affect to the drug release of sustained release indomethacin tablets were investigated in the laboratory. The results showed that amount of Xanthan gum, dicalcium phosphate, talc-magnesium stearate and sodium laurylsulphate involved in the tablets had influenced on the drug release. The suitable formulation of tablets was chosen and some of its criteria were established
Indomethacin ; Pharmaceutical Preparations ; Tablets

The goal: Pellet was introduced into sustained release product containing indometacin to promote the advantage of this drug form. The material: Indometacin (China), avicel pH 101 (Taiwan), lactose (Holland), polyvinylpyrolidon (Holland), hydroxypropyl methylcellulose (England)… The method: Pellet indometacin was prepared by layering method. The result: the optimal formulary to prepare sustained release pellet indometacin using layering method was selected. Coated pellet may be filled into the capsules shell or compressed into tablet having sustained release effect by oral (up to 12h)
Indomethacin ; Pharmaceutical Preparations ; Capsules

No abstract available.
Bartter Syndrome* ; Indomethacin

No abstract available.
Animals ; Indomethacin* ; Mice*