minocycline and Dementia

The aim of this study was to develop a pH-independent extended release matrix tablet of minocycline HCl for the treatment of dementia. The matrix tablets were prepared by wet granulation technique using Eudragit L and S as release modifiers at different w/w ratios (1:0, 1:1 and 0:1) and PEO as a matrix former. In the case of the matrix tablet without any release modifiers, the drug release rate at pH 1.2 was much higher than that of pH 7.4. By adding the release modifier, the drug release rate at pH 7.4 increased close to that of pH 1.2 and the pH-independent release was obtained. In addition, it was shown that lubricants containing a divalent cation such as Mg stearate inhibited minocycline release in basic medium. Therefore, the incorporation of Eudragit L and S (1:1 ratio) as release modifiers and Na stearyl fumarate as a lubricant into PEO-based matrix tablets effectively produced pH-independent minocycline release profiles.

Topics: Animals; Anti-Bacterial Agents; Delayed-Action Preparations; Dementia; Excipients; Fumarates; Humans; Hydrogen-Ion Concentration; Lubricants; Minocycline; Polyethylene Glycols; Polymethacrylic Acids; Tablets

We present three cases of rare side effects which appeared to be attributable to antibacterial drug treatment. A 57-year-old female patient was admitted to hospital due to increasing dyspnea. Computed tomography revealed interstitial lung fibrosis which was attributed to the toxic effects of nitrofurantoin (50 mg/d) that the patient used for approximately one year for recurrent urinary tract infection. She died two weeks after hospital admission due to acute respiratory failure. A 20-year-old male patient presented with most intense headache and psychomotor deceleration. Pseudotumor cerebri, which was suspected to be the underlying cause, is described as a rare side effect of minocyclin which the patient has taken for acne pustulosa (100 mg single dose). After dechallenge of minocyclin, neurological symptoms quickly subsided. A 82-year-old female patient used moxifloxacin (400 mg/d) for febrile bronchopulmonary infection for one week. During this therapy, confusion and severe dementia presented and remained for more than two months after discontinuation. The demential syndrome appears to be possibly related to the fluoroquinolone use. In summary, adverse drug effects not pertaining to the primary physician's field are especially difficult to identify. Most importantly, rare side effects must be borne in mind by the prescribing physician.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Urinary; Aza Compounds; Dementia; Female; Fluoroquinolones; Humans; Male; Middle Aged; Minocycline; Moxifloxacin; Nitrofurantoin; Pseudotumor Cerebri; Pulmonary Fibrosis; Quinolines; Young Adult