摘要:

Treatment with selegiline produced profound hypoglycemia in a 70‐year‐old man with Parkinson's disease. The hypoglycemia was accompanied by hyperinsulinemia and persisted for 1 week after selegiline was discontinued. Although this side effect of antidepressant monoamine oxidase inhibitors was well documented in 1959–1968 publications, it was not known to the manufacturer of selegiline. Effects of drugs on glucose metabolism may be predictable through a novel molecular modeling technique developed in our laboratories, which shows that glucose exhibits stereochemical complementarity to a specific site in partially unwound DNA. Selegiline and other molecules affecting glucose metabolism fit into the same DNA base sequence. It therefore should be possible to employ this technique to identify pharmaceutical agents that possess hypoglycemic or hyperglycemic effects in

ISSN:0091-2700    

DOI:10.1002/j.1552-4604.1994.tb03969.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The risk inherent in the clinical control of patients with theophylline is widely recognized. Elderly patients may present an additional risk because of altered pharmacokinetics and the use of concomitant medication. Acetylsalicylic acid has been proposed for primary and secondary prevention of myocardial infarction and possible strokes. This investigation was undertaken to determine if concomitant administration of acetylsalicylic acid in elderly patients would alter steady‐state levels of theophylline. A population of smoking male patients older than 60 years of age under long‐term control of chronic obstructive pulmonary disease (COPD) with theophylline were evaluated for a baseline period of 3 days. Serum levels were measured at 6:00amand 6:00pm.An enteric‐coated acetylsalicylic acid preparation, 650 mg by mouth, was added to the daily slow‐release theophylline, 6:00amhour dose regimen for 4 weeks. The serum levels of theophylline and salicylates were measured at 6:00pmafter dosing and at 6:00amthe following day, at weekly intervals for 4 weeks. Urine specimens collected before administration of medication at 6:00amwere analyzed for salicylates to further confirm dosage compliance. All volunteers continued to be clinically controlled throughout the treatment period, and no symptoms of either overdose or underdose of either medication occurred. Plateau or trough theophylline serum levels did not change significantly during the salicylate treatment period. Salicylate serum levels did show during treatment self‐induced metabolism. It is concluded that in elderly male patients, a daily concomitant therapeutic salicylate regimen does not alter steady‐state serum theophylline levels and therefore does not per se necessitate the assay of theophylline blood levels in elder

ISSN:0091-2700    

DOI:10.1002/j.1552-4604.1994.tb03970.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Eleven patients with moderate to severe hypertension were studied at the Vargas Hospital of Caracas. The patients were pretreated with labetalol, 800 to 1200 mg/day, orally, over a period of 1 week, after which an intravenous infusion of dopamine, .5 to 3 μg/kg/minute, was given. Two intravenous dopamine infusions (30 minutes each) were performed before and after the injection of metoclopramide (30 mg, intravenous bolus). Two washout periods were also included before and after metoclopramide administration. Dopamine induced a decrease of blood pressure from 171.9 + 6.35/103.6 ± 3.12 to 152.7 ± 7.55/93.8 ± 2.97 mm Hg (P<.001) without altering heart rate, and it increased plasma insulin levels from 8.29 ± .70 μU/mL to 12.09 ± 1.83 μU/mL (P<.01). Metoclopramide caused no changes of blood pressure or plasma insulin levels. Hypotensive responses and plasma insulin increases due to dopamine were blocked by metoclopramide, however. The authors conclude that a dopaminergic receptor may be involved in some cardiovascular responses and in modulating insulin secretion in

ISSN:0091-2700    

DOI:10.1002/j.1552-4604.1994.tb03971.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY