Electrocardiographic recordings of psychiatric patients attending Dawanau Psychiatric hospital, Kano-Nigera

Psychiatric patients are often associated with electrocardiographic (ECG) abnormalities which may in some cases be life threatening due to the effect of anti psychotic drugs they are placed on. This study aims to establish the ECG recordings of these patients and find out if there exist abnormalities in the ECG tracings as documented in the literature. Anthropometric and clinical data were obtained from 323 patients attending Dawanau Psychiatric Hospital between April to May 2017. Result showed there were 12 (3.7%) cases of short PR interval and 15 (5%) of prolonged PR interval. Fifteen (5%) of the subjects have prolonged QTc, 16 (5%) have ST segment elevation while 8 (2.5%) have ST segment depression and 24 (7.4%) have flat T wave. The PR and QT intervals were significantly (p<0.05) lower in females compared to the males, while the corrected QT was significantly (p<0.05) lower in the males than the females. It can be concluded that mild ECG changes exist in these psychiatric patients on antipsychotic drugs, but there was no late ventricular potentials or features of Torsade de pointes.Keywords: ECG, Antipsychotic drugs, Dawanau, Kano, Nigeria, Psychiatric Patients

Influence of Metronidazole on the Pharmacokinetics of Metformin in Type II Diabetic Patients

Infection is common in diabetes and metronidazole is often co-administered with metformin. This study is therefore to examine the influence of concomitant administration 400 mg dose metronidazole tablet with (2x500mg) metformin on pharmacokinetic parameters of metformin in type II diabetic Patients. The approval for the research was granted by the Ethical Committee of Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Six Type II diabetic patients with age ranging from 25-55 years, weight from 50-70 kg took part in the study. Each of the six patients received the following treatment at two weeks intervals; Metformin tablet (1gm alone and concomitantly with 400 mg metronidazole tablets. Blood samples were collected at interval of 0 to 8 hours and stored at -40C before analysis. High performance liquid chromatography (HPLC) was adopted, modified and validated to measure the plasma levels of metformin in the samples. Samples were chromatographed on Agilent Technologies 1120 Compact LG model of HPLC, on column Eclipse x BD C-8,4.6 x 150 nm for metformin with mobile phase acetonitrile: potassium dihydrogen orthophosphate (79:21) with flow rate of 1.50 mL/min, using UV detector. The results obtained altered the pharmacokinetic parameters of metformin significantly. The highest plasma concentration increased from 1140.43±0.52 to 1326.67±0.4 ng/ml at Tmax 3.0 hours, with increase in area under the plasma concentration – time curve from 4388.81±0.52 to 5361.84±0.80 ng/ml/h. Significant decrease in volume of distribution from 333852.19±0.87  to 313, 061.43 ± 0.02ml was also observed. The results showed that metronidazole has potentiation effect on the disposition of metformin when concomitant administered to type II diabetic patients. Diabetic patients who require metronidazole needs adjustment of dosage regimen to avoid the risk of toxicity

Influence of ampicllin/cloxacilin combination on pharmacokinetics of metformin in type II diabetic patients

Infection is common in diabetes and ampicillin/cloxacillin combination (Ampiclox®) is often coadministered with metformin. The study examined the influence of concomitant administration of a single dose of (2 x 500 mg) capsules of Ampiclox with (2 x 500 mg) metformin on the pharmacokinetics of the latter in Type II diabetic patients. The approval for the research was granted by the Ethical Committee of Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Six Type II diabetic patients with ages ranging from 25 - 55 years, weight from 50-70 kg took part in the study. Each of the six patients received the following treatments at two weeks intervals: 1 gm of metformin tablets alone and concomitantly with Ampiclox capsules. Blood samples were collected at intervals of 0 to 8 h and stored at -40C before analysis. High performance liquid chromatography (HPLC) was adopted, modified and validated to measure the plasma levels of metformin in the samples. Samples were chromatographed on Agilent Technologies 1120 Compact LG model of HPLC, on column Eclipse x BD C-8,4.6 x 150 nm for metformin with mobile phase acetonitrile: potassium dihydrogen orthophosphate (79:21), using UV detector. The results obtained from the study indicated a statistically significant (P < 0.5) increase in the plasma concentration (Cmax) of metformin from 1140.43±0.52 to 1,379.55±0.4 ng/ml at Tmax 3.0 h, AUC0- 8hrs from 4388.81±0.52 to 5179.71±0.80 ng/ml/hr and elimination half-life t1/2β from 3.8 to 5.1 hr-1. Statistically significant decrease in volume of distribution from 333,852.19.28 ± 0.27 to 283,061 ± 0.02 ml was also recorded. Ampiclox must have inhibited the renal secretion of metformin resulting in higher circulating plasma concentrations. Patients on metformin who require Ampiclox , need therefore to be monitored to avoid therapeutic failure.Keywords: Ampiclox®, Diabetes, HPLC, Metformin, Pharmacokinetic