摘要:

Amrinone is the first noncatecholamine inotropic agent with substantial vasodilating properties to be approved by the Food and Drug Administration. Its use in acute congestive heart failure (CHF) is associated with significant increases in cardiac index, reductions in pulmonary capillary wedge pressure and systemic vascular resistance and little or no change in mean arterial pressure. Pharmacokinetic studies of amrinone report an elimination half‐life of 2.6–8.3 hours, with slower elimination more likely in patients with compromised renal or hepatic function. Intravenous bolus doses of 0.75–3.5 mg/kg followed by infusions of 5–20 μg/kg/min produce hemodynamic improvements similar to those with dobutamine. Side effects with amrinone therapy are usually mild, but thrombocytopenia occurs in 2.4% of patients. Amrinone appears equally as efficacious as dobutamine in the management of acute CHF, but its role in therapy depends on efficacy and side effect data in greater numbers of

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03422.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Ceftriaxone is an aminothiazolyl‐oxyimino cephalosporin. It possesses the typical in vitro activity of a third‐generation cephalosporin with excellent activity against many gram‐negative aerobic bacilli:Escherichia coli; species ofProteus, Klebsiella, Morganella, ProvidenciaandCitrobacter; andEnterobacter agglomerans. Ceftriaxone also has outstanding bactericidal action against pneumococci, group B streptococci, meningococci, gonococci andHemophilus influenzae. In healthy volunteers, it has an exceptionally long serum half‐life of 5.8–8.7 (mean 6.5) hours. It distributes well throughout all body spaces, including cerebrospinal fluid in the presence of inflammation. Dosage modification is necessary only when there is combined hepatic and renal dysfunction. Adverse reactions characteristic of cephalosporins have been observed with the administration of ceftriaxone. No unique toxicities have been identified, and hypoprothrombinemic bleeding is not part of the adverse reaction profile. Ceftriaxone has been used to treat serious bacterial infections in neonates, infants, children and adults. Bacteriologic and clinical success rates have consistently exceeded 90%. The drug has also been used as single‐dose chemoprophylaxis in coronary artery bypass, biliary tract, vaginal hysterectomy and prostatic surgery. Efficacy and safety were similar to multiple‐dose cefazolin. Ceftriaxone warrants special consideration because its extended half‐life allows for less frequent dosing than other antimicrobials. Significant cost savings can be realized with proper use of

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03423.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Ceftazidime is an aminothiazolyl cephalosporin with potent activity against gram‐negative bacteria including multiresistant strains ofPseudomonas aeruginosa. It has limited activity against gram‐negative anaerobes, is less active against some gram‐positive cocci than other newer beta‐lactam compounds and is inactive againstStreptococcus faecalisand methicillin‐resistantStaphylococcus aureus. Ceftazidime is stable against common plasmid and chromosomally mediated beta‐lactamase produced byEnterobacteriaceaeandPseudomonassp. Its pharmacokinetic properties are similar to those of moxalactam and ceftizoxime, and it has a half‐life of 1.9 hours. Excretion is by glomerular filtration. It is not metabolized. Ceftazidime penetrates into most body tissue and fluids, including cerebrospinal fluid, and produces therapeutic levels against most of the pathogenic gram‐negative bacteria, includingP. aeruginosa. Ceftazidime accumulates during renal failure, but is removed by hemodialysis and peritoneal dialysis. As a single agent it has been shown effectively to treat meningitis; urinary tract infections; gram‐negative pneumonia; bone, joint and skin infections; and obstetric and gynecologic infections due to susceptible organisms. When combined with an agent that is effective against gram‐positive organisms, it is also beneficial in the treatment of infections in seriously ill neonates. Different investigators have used ceftazidime alone or in combination with other agents in the successful treatment of infections in immuno‐suppressed patients. Adverse reactions have been few and are mostly reversible laboratory findings. The effects of ceftazidime on prothrombin synthesis and platelet function have been minimal, and no drug‐induced clinical ble

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03424.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The risk of epilepsy or afebrile seizures after convulsions in the neonatal period is compared with the benefits and risks of chronic use of anticonvulsants in infants. The best predictor of later seizures appears to be the presence of moderate to severe neurologic damage. In the absence of such deficits, the risk is below 10%, but increases to 50–70% when damage is severe. A comparison of reports indicates no difference in seizure recurrence rates when anticonvulsants are stopped early in the neonatal period or when treatment is longer, even in the high‐risk group. After phenobarbital is discontinued and the plasma concentration falls below the therapeutic range, seizures usually recur within a few days or not for several months. Only 50% of these seizure types are expected to be controlled with phenobarbital. Long‐term phenobarbital use is associated with impaired cognitive function in infants and toddlers, and retarded brain growth in rodent st

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03425.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Seizures occurring in the neonatal period are one of the most significant discriminating factors in predicting childhood neurologic mortality and morbidity (epilepsy, cerebral palsy and mental retardation). Data derived from retrospective and prospective studies indicate that different variables, such as cause and severity of seizure activity, birth weight, neurologic examination and electroencephalogram, help predict which of these children will be severely affected. Most physicians treat such children with an anticonvulsant (phenobarbital) for the first year of life on the supposition that this therapy will minimize mortality and long‐term morbidity. There are no controlled studies to indicate whether anticonvulsant therapy affects the outcome in children with neonatal seizures. It may now be possible to select those who are at significantly higher risk for neurologic morbidity, and these infants may benefit from anticonvulsant prophylaxis with phenobarbita

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03426.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03427.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

In this follow‐up study we attempted to estimate the risk of hospitalization for upper gastrointestinal bleeding (exclusive of bleeding from duodenal ulcer) caused by taking certain nonsteroidal antiinflammatory drugs (NSAIDs) in people below the age of 65 years. The final figures represent our best estimate, taking into account all of the available information, and suggest that NSAIDs (excluding aspirin) rarely cause gastrointestinal bleeding from the stomach that requires hospitalization in this age group. A formal analysis of the data according to classic techniques was not feasible since numerous important confounding factors could not be controlled. Indeed, the results indicated that such formal analysis is unnecessary. The data as they stand are of considerable value in providing a reasonable estimate of attributable risk for the drugs studie

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03428.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The antihypertensive activity of terazosin, an investigational alpha1‐adrenergic‐receptor blocker, and its effect on blood lipids were compared with placebo in a double‐blind study. After a 3‐week placebo baseline period, patients were randomized to receive terazosin (n = 22) or placebo (n = 16). The dose of terazosin was titrated over 2 weeks to a maintenance dosage of 10 mg once daily for 4 weeks. Antihypertensive efficacy was assessed: (1) at the end of the 24‐hour dosing interval by comparing the average blood pressure (BP) after 3 and 4 weeks of maintenance therapy to the average BP after 2 and 3 weeks of placebo therapy, and (2) for 3 hours after drug ingestion at the final visit in comparison to the predose BP at that visit. At the end of the 24‐hour dosing interval, 10 mg of terazosin reduced the mean supine systolic BP from 155.6 to 152.2 mm Hg and mean supine diastolic BP from 101.9 to 99.0 mm Hg (p<0.05). During the 3 hours after drug ingestion, mean supine systolic and diastolic pressures decreased maximally from 151.8 to 142.7 mm Hg (p<0.05) and from 99.5 to 91.0 mm Hg (p<0.05) respectively. No supine BP reduction differed significantly from the placebo response. During terazosin therapy there was a nonsignificant increase in mean body weight of 1.4 ± 2.9 kg and no change in blood lipids. Thus the drug demonstrated greater antihypertensive activity 1–3 hours after ingestion than at the end of the 24‐hour dosing interval. The role of terazosin 10 mg once daily in the treatment of mild to moderate hypertension remains t

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03429.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A total of 66 outpatients meeting Diagnostic and Statistical Manual (DSM‐III) criteria for generalized anxiety disorder began treatment in a randomized double‐blind study that compared the efficacy and safety of buspirone and diazepam. Thirty‐nine outpatients completed the 4‐week trial. Both drugs were administered in a 1:1 dosage ratio; the daily prescribed dose did not exceed 40 mg. The mean daily dose of buspirone prescribed thoughout the study was significantly higher than that of diazepam. Diazepam had a significantly earlier onset of efficacy than buspirone, although both drugs were equivalent after 4 weeks of treatment. Adverse reactions were more frequent in the diazepam group. Total scores from the Hamilton anxiety scale and physician's global ratings show that diazepam was significantly superior to buspirone during the initial 2 weeks of treatment. These findings are further corroborated by the results of patients' self‐rat

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03430.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1985.tb03432.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY