ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02683.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The pharmacokinetics and pharmacodynamics of ranitidine and famotidine were studied in 13 healthy elderly volunteers. On 3 mornings separated by a 1‐week wash‐out period, each subject received a single oral dose of ranitidine 300 mg, famotidine 40 mg, and placebo in a crossover, randomized fashion with double‐dummy administration. Plasma and urine concentrations of ranitidine and famotidine were determined by high‐performance liquid chromatography. Intragastric pH was measured for 24‐hours with an antimony probe. Famotidine's plasma half‐life (4.42 hrs) was significantly longer than ranitidine's (3.14 hrs, p<0.05, pairedttest). The 24‐hour, area under the curve of pH profiles of the two drugs were significantly different from placebo (p4) was similar for ranitidine and famotidine, 10.3 and 9.9 hours, respectively (p=0.713, paired Student'sttest). Thus both agents exhibited a similar duration of 24‐hour antisecretory response under these s

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02684.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Clearance of the radiopharmaceutical Tc‐99m DTPA estimated from blood samples with no urine collection can provide a reliable estimate of glomerular filtration rate (GFR) in adults, but has not been well studied in children. The disposition of Tc‐99m DTPA was determined in 17 children with cancer, and the influence of binding and study design on the estimates for serum clearance were evaluated. Nine blood samples were obtained over 6 hours in each patient, and serum was assayed for total and free Tc‐99m. Free Tc‐99m DTPA was determined by ultrafiltration. Estimates of clearance derived from a two‐compartment model for ultrafiltrable Tc‐99m DTPA were determined from all nine measured concentrations, and these results served as a reference value for GFR in each subject. Total Tc‐99m DTPA concentrations also were best described by a two‐compartment model, but the median total clearance (35 ml/min) was significantly (p<0.01) lower than the ultrafiltrate clearance (58 ml/min). The effect of a simplified sampling schedule was assessed from clearance estimates based on a 3‐point subset of the ultrafiltrable data. The median clearance of 69 ml/minute was significantly higher (p<0.01) than the reference GFR. However with a correction factor included to account for the positive bias arising from the limited sampling schedule, the reference estimates for GFR were well predicted (r2=0.99) with no significant bias. Ultrafiltrable Tc‐99m DTPA serum clearance using a limited sampling schedule can provide a consistent and clinically feasible estimate of glomerular filtration rate in children, but binding in serum and study design are potentially important

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02685.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Protein catabolism occurs in the severely stressed patient despite adequate protein supplementation. Supplementation of endogenous growth factors is one mechanism being evaluated to promote anabolism and improve nitrogen retention. Recombinant technology has provided a means to reproduce these endogenous growth factors. Both recombinant human growth hormone (rGH) and recombinant human insulin‐like growth factor‐1 (rhIGf‐1) are undergoing clinical trials to establish their roles in nutritional su

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02686.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Preterm labor is defined as the onset of uterine contractions in a woman who has completed less than 37 weeks of pregnancy. It may be due to maternal, placental, fetal, or idiopathic causes, and it is associated with a number of risk factors. Nondrug measures such as bedrest and hydration have been used alone or in combination with drug therapy to treat the disorder. Pharmacologic (tocolytic) agents include ethanol, progesterone, indomethacin, nifedipine, β‐adrenergic agonists, and magnesium salts. The three most commonly used drugs are ritodrine, terbutaline, and magnesi

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02687.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Gynecomastia is a relatively common physical finding in men. A wide variety of drugs have been implicated in its cause. Sufficient evidence in the literature suggests that calcium‐channel blockers, cancer chemotherapeutic agents, and histamine2‐receptor blockers may play a role in the disorder. Evidence for digitalis glycosides and neuroleptic agents is insufficient. Ketoconazole and spironolactone can also produce gynecomastia, and data for marijuana are contradictory. Large numbers of drugs have only case reports of temporal association with the disor

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02688.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Omeprazole is a member of a new class of substituted benzimidazoles. These agents inhibit the proton pump in the gastric parietal cell, blocking the final step in the gastric acid secretory pathway. Omeprazole has been investigated for the treatment of gastric ulcer, duodenal ulcer, gastroesophageal reflux, and various hypersecretory states. The prolonged inhibition of gastric acid secretion allows for once‐daily dosing in patients with peptic ulcer disease and gastroesophageal reflux, and once‐ or twice‐daily dosing in patients with Zollinger‐Ellison syndrome. Compared with currently available therapies, omeprazole is well tolerated and demonstrates a more rapid ulcer healing rate. It is superior to conventional therapies in the treatment of Zollinger‐Ellison syndrome. Side effects are infrequent when the drug is used for the short‐term managemen

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02689.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We investigated whether serum Δ osmolality will predict the total serum concentration of isopropanol and acetone metabolite. Three isopropanol ingestions were monitored by Δ osmolality determinations followed by quantification of serum isopropanol and acetone concentrations. The Δ osmolality was established by routine chemical analysis and standard freezing point depression osmometry. Serum isopropanol and acetone levels were quantified by gas chromatography‐head space analysis (GC‐HS). Patients were initially suspected of having isopropanol intoxication secondary to an elevated Δ osmolality discrepancy (measured ‐ calculated>10 mOsm). Serum concentrations versus Δ osmolality were analyzed by linear regression (correlation coefficient r=0.713; p<0.05). The Δ osmolality paralleled and decreased relative to the total low molecular weight of volatile concentration in each case. In emergencies, Δ osmolality may be a screening test to identify rapidly patients at risk for complications associated with isopropanol ingestion when GC‐HS is

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02690.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The administration of intermittent intravenous infusions of cimetidine is infrequently associated with the development of bradyarrhythmias. A 40‐year‐old man with leukemia and no history of cardiac disease developed recurrent, brief episodes of apparent sinus arrest while receiving continuous‐infusion cimetidine 50 mg/hour. The arrhythmias were temporally related to cimetidine administration, disappeared after dechallenge, and did not recur during ranitidine treatment. This is the first reported case of sinus arrest associated with continuous‐infusion cim

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02691.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A 63‐year‐old man with ventricular tachycardia (VT) refractory to drug therapy was admitted for surgical ablation of the VT with coronary artery bypass graft surgery. He developed increased theophylline concentrations with decreased calculated theophylline clearance after propafenone therapy for recurrent VT was initiated. Within 1 day after the addition of propafenone 150 mg every 8 hours to a drug regimen that included theophylline sustained‐release tablets 300 mg every 12 hours, the patient demonstrated increased theophylline serum concentrations and decreased calculated theophylline clearance. Despite a decrease in theophylline dosage, theophylline concentrations continued to rise as the dosage of propafenone was increased to 300 mg every 8 hours. Theophylline was discontinued due to a rising theophylline level, improved oxygenation, and absence of wheezing. Both propafenone and theophylline are hepatically metabolized by the cytochrome P‐450 enzyme system. The decrease in theophylline clearance of 25% to 69% in this patient may be due to competitive metabolism resulting in enzyme inhibition and increased theophylline concentrations. Since propafenone and 5‐OH‐propafenone levels were not measured, it is unknown whether propafenone clearance was affected as well. Health care practitioners should be aware of this possible drug interaction and monitor theophylline concentrations and the electrocardiogram closely if the agents are coa

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1993.tb02692.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY