摘要:

The influence of chronic (>1 yr duration) spinal cord injury (SCI) on the disposition of amikacin was studied in seven healthy subjects with SCI (five paraplegic, two tetraplegic) and seven able‐bodied controls (intact neuraxes). The time course of amikacin serum concentration after a 30‐minute infusion (7.5 mg/kg) was followed for up to 8.5 hours using fluorescence polarization immunoassay. Pharmacokinetic values were estimated by a noncompartmental analysis (NC). Amikacin steady‐state volume of distribution (Vss) was increased to 0.20 ± 0.04 l/kg (mean ± SD) as compared to 0.17 ± 0.02 l/kg in able‐bodied controls (p 0.03), and its mean terminal elimination half‐life in patients with SCI was prolonged by 0.64 hours over the control value of 2.11 ± 0.27 hours (p 0.01). The NC estimated mean residence time (MRT) in patients with SCI (3.65 ± 0.75 hrs) was 0.89 hours longer than that observed in controls (p 0.03). Our data suggest that the Vss, half‐life, and MRT of amikacin are increased in persons with chronic SCI. As a result, amikacin dosing regimens developed in able‐bodied humans may demonstrate diminished efficacy when extrapolated uncritically

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03539.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The predictive performance of 2 theophylline pharmacokinetic dosing programs (Abbott and Simkin) was evaluated using a group of 44 inpatients who had 2 serum concentrations (TSC) measured during hospitalization. Bias was assessed with the median prediction error (PE) and precision was assessed with the median absolute PE. The Abbott program was significantly less biased than the Simkin program in predicting the first TSC (PEs 0.1 and −1.3 μg/ml, respectively; p<0.05). No significant difference in bias was observed in predicting the second TSC, or in precision in predicting either the first or second TSC. Both programs exhibited small improvements in prediction precision when the first TSC was used to predict the second. Correlations of predicted versus measured TSC also improved with the second prediction. These programs may be useful in dosing theophylline; however, TSC monitoring and the application of sound clinical judgment are warrant

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03540.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Antiarrhythmic drugs frequently cause extracardiac side effects that limit their use. If intracoronary delivery of a lower dose of drug to an electrically unstable focus can control arrhythmias, systemic adverse effects of these agents might be avoided. We investigated whether intracoronary lidocaine can suppress ventricular arrhythmia induced by acetylstrophanthidin, a rapidly acting digitalislike agent. We isolated and then cannulated either the left anterior descending or the left circumflex coronary artery in 12 pentobarbital‐anesthetized dogs. Sustained ventricular tachycardia that persisted for 11.4 ± 8.6 minutes was reliably induced by the intracoronary infusion. In all of 24 trials, an intracoronary lidocaine bolus at 2% of the usual systemic dose (0.77 mg/30 sec) abolished digitalis‐induced ventricular tachycardia for an average of 2.0 ± 1.8 minutes. This effect was not observed after a saline bolus. We conclude that an intracoronary bolus of low‐dose lidocaine can suppress acetylstrophanthidin‐induced ventricular a

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03541.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Hemophilia A and von Willebrand's disease are hereditary disorders associated with qualitative and quantitative abnormalities of clotting factor VIII. A major clinical feature is excessive or abnormal bleeding often necessitating the use of transfusions of pooled blood products to achieve hemostasis. Exposure to blood products places the recipient at risk for infection by the hepatitis B virus or the human immunodeficiency virus. A synthetic analog of arginine vasopressin, 1‐desamino‐8‐d‐arginine vasopressin, has been shown to increase the plasma levels of factor VIII coagulant activity and von Willebrand's factor, and clinically to improve abnormal bleeding, obviating the need to use blood p

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03542.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Buspirone (Buspar) is a azaspirodecanedione anxiolytic agent. Its mechanism of action is extremely complex, but current investigations indicate that its main neuropharmacologic effects are mediated by the 5‐HT1Areceptors. Other neuroreceptor systems could be involved, as buspirone displays some affinity for DA2autoreceptors and 5‐HT2receptors. It has been proposed that inhibition of synthesis and release of serotonin result through the combined interactions of neuroreceptors and secondary messenger systems. This action leads to inhibition of the firing rate of 5‐HT‐containing neurons in the dorsal raphe. From this novel profile, that differs from that of the benzodiazepines, buspirone lacks anticonvulsant and muscle‐relaxant properties, and causes only mimimal sedation. The drug is rapidly absorbed after oral administration, with a mean bioavailability of 3.9%. After a single oral dose, the mean elimination half‐life is 2.1 hours. Buspirone is mainly bound to albumin and oxacid glycoprotein. It is metabolized to an active metabolite 1‐(2‐pyrimidinyl) piperazine (1‐PP). The mean elimination half‐life of 1‐PP is 6.1 hours. Buspirone is indicated in the treatment of generalized anxiety disorders. Its efficacy is comparable to the benzodiazepines. Its use in depression and panic disorders requires further investigation. When combined with alcohol or given alone, psychomotor impairment was not detected. Abuse, dependence, and withdrawal symptoms have not been reported. The frequency of adverse effects is low, and the most common effects are headaches, dizziness, nervousness, and lightheadness. Buspirone should be added to drug formularies and could represent a significant addition

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03543.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1988.tb03544.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY