摘要:

Currently available anesthetic induction agents provide adequate hypnosis but are not ideal, particularly in the high risk patient (ASA class III‐V), because most cause myocardial and/or respiratory depression and some have other important side effects. Etomidate was recently marketed as an intravenous anesthetic induction agent. It is a non‐barbiturate hypnotic without analgesic properties that has less cardiovascular and respiratory depressant actions than sodium thiopental, even in patients with minimal cardiovascular reserve. Laboratory studies indicate that etomidate is approximately 25 times more potent and has a therapeutic index six times greater than sodium thiopental. In contrast to most other induction agents, etomidate does not cause histamine release. Furthermore, tolerance does not occur with repeated administration. Etomidate's rapid distribution half life (t1/2α= 2.81 ± 1.64 min), short elimination half life1/2β= 3.88 ± 1.11 hr) and rapid clearance (954 ± 178 ml/min) explain its rapid onset and short duration of action. The compound produces electroencephalographic changes and effects on cerebral blood flow, metabolism and intracranial pressure that are similar to sodium thiopental, suggesting that it may have a place in neurosurgery and as a “brain protective” agent in patients at risk of a brain hypoxic insult. Etomidate did not affect hepatorenal and hematologic function after repeated injections in animal toxicology studies, but few investigations addressing its effects on hepatic, renal, and neuromuscular function in man have been accomplished. The most noticeable side effects of etomidate include myoclonia, pain on injection and postoperative nausea and vomiting. Etomidate's most likely application will be as an anesthetic induction agent in patients with significant cardiovascular and/or respiratory disease or increased intracranial pressure, in patients with evidence of allergy to the barbiturates, and in combination with nitrous oxide in patients about to undergo shor

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03266.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03268.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Vindesine is a new vinca alkaloid antineoplastic agent derived from vinblastine. However, its antineoplastic spectrum more closely resembles that of vincristine. Clinical studies indicate activity against acute leukemia, lung cancer, carcinoma of the breast, squamous cell carcinoma of the esophagus and head and neck, Hodgkin's disease and non‐Hodgkin's lymphomas. Pharmacokinetic studies indicate that vindesine exhibits a triphasic elimination pattern with a terminal half‐life of 24.2 hours. Elimination is primarily through hepatic metabolism. The major side effects associated with vindesine therapy are myelosuppression and neurotoxicity. Other side effects include alopecia, nausea and vomiting and local tissue irritation associated with extravasation. Vindesine will be a positive addition to the antineoplastic armamentarium. The full extent of its activity remains to be establis

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03269.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03271.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03273.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Acyclovir is a new antiviral drug that acts as a specific inhibitor of herpesvirus DNA polymerase. It shows good in vitro activity against herpes simplex and varicella‐zoster viruses. The drug may be administered topically to the skin, intravenously, orally, or topically to the eye (only topical and intravenous preparations are currently available). Acyclovir kinetics are described by a two‐compartment open model. The drug and its metabolites are excreted by the kidney via glomerular filtration and tubular secretion. Dosage adjustment is required in patients with renal failure. Safety and tolerance studies in animals and humans have shown acyclovir to be very well tolerated. The most important adverse effect is crystalluria and elevated serum creatinine related to bolus intravenous administration. Other reported adverse effects include infusion site inflammation and rash. Topical acyclovir is effective for treating initial genital herpes and mucocutaneous herpes in the compromised host, but has not been shown to be clinically useful for recurrent labial or genital herpes. Intravenous acyclovir is effective for mucocutaneous herpes infections in the compromised host and initial genital herpes in the normal host; it is being evaluated for the treatment of herpes simplex virus encephalitis and varicella‐zoster infections. An investigational oral preparation may prove to be effective therapy for both initial and recurrent genital herpes. Acyclovir therapy does not eliminate latent virus or prevent subsequent recurr

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03274.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03276.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The mechanism of action of auranofin, an oral organic gold compound used in the treatment of rheumatoid arthritis, is probably similar to the previously available parenteral gold compounds. Auranofin affects polymorphonuclear cells and monocytes at lower concentrations than gold sodium thiomalate and generally affects humoral and cell‐mediated immunity in the same direction as the latter drug. The pharmacokinetics of auranofin are different from the intramuscular gold compounds. Auranofin is 20–25% orally absorbed and has less total body retention, greater fecal excretion, and less urinary excretion than gold sodium thiomalate. This may be due in part to its differing chemistry, including its lipophilicity and monomeric structure (at least in vitro). While many clinical studies are not yet complete, auranofin (6 mg/day) is clearly more effective than placebo for treating rheumatoid arthritis. Its efficacy relative to gold sodium thiomalate is not clear. Auranofin may be slightly less effective than gold sodium thiomalate, but because it is generally less toxic than intramuscular gold compounds, its therapeutic index may be more favora

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03277.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03278.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1983.tb03280.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY