Biomedical subjects
Publications and source records attributed to A M MacConnachie.
This, the last article in the series, describes the administration of analgesics other than via the enteral route in the treatment of chronic severe pain.
The introduction of leucocyte growth factors produced by DNA biosynthetic technology has had a major impact on survival in patients with compromised immunity. Such agents have maximized the benefits of treatment with drugs which are otherwise potentially toxic to the bone marrow.
Cystic fibrosis is a devastating illness affecting the young, in particular, and for which no cure exists. Any new treatment which might improve quality of life and prolong survival is to be welcomed but, so far, there are still several questions to be answered concerning the role of dornase-alfa.
In this, the third article in the series, the role of analgesic drugs appropriate for the treatment of moderate to severe pain is reviewed along with therapies frequently applied in the treatment of poorly responsive neurogenic pain. The article should be read in conjunction with part one outlining general principles in the management of chronic pain.
Reluctance to commence treatment with a Step 3 drug on the Analgesic Stepladder is a common reason for failure to manage chronic severe pain in many situations. The fourth article in the series reviews the potent opioid analgesics for oral use and in doing so addresses the various prejudices that surface when such therapy is denied.
Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.
Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.
Docetaxel is the latest in a new class of cytotoxic drug having a specific action on dividing cells. It is potentially a useful, if expensive, treatment for some common cancers in which the response to existing treatments has been generally disappointing.
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The glycopeptides are important antibiotics in the management of Staphylococcal infections. Teicoplanin, the latest member of the group, may offer some advantages over vancomycin, the workhorse drug, which has retained its importance in the presence of increasing major resistance to other antistaphylococcal agents.
Hypercalcaemia is a disabling and lifethreatening complication in some patients with cancer. Bisphosphonates, including pamidronate, provide an effective means of lowering dangerously high calcium levels.
Alternative forms of amphotericin injection have been introduced in recent years. Though better tolerated and less toxic to kidney tissues, they are substantially more expensive than conventional amphotericin and their use is best reserved for specific indications.
The substance Ecstasy, which has become synonymous with the rave culture, has received much attention in recent times as a result of several well-publicized deaths among young 'users'. What is Ecstasy and what is the management of its toxicity in patients admitted to hospital?
Catecholamine inotropes, chemically based on dopamine and active in the sympathetic nervous system, are used to provide haemodynamic support to critically ill patients. The latest of these, dopexamine, is a promising addition to this important class of drugs with wide application in intensive care.
The non-steroidal anti-inflammatory drugs (NSAIDs) are an important group widely prescribed in general medical practice. the availability of a few NSAIDs in injectable form provides an important approach to pain management.
A new class of anticoagulant with advantages over standard heparin were introduced in 1990. Collectively termed low molecular weight heparins, their role is increasing in the treatment and prophylaxis of thromboembolism.
Almost 30 years after its introduction, gentamicin continues to play a key role in the treatment of gram negative sepsis. Once-daily dosing may offer a more effective, safer and economic use for this important antibiotic.
During the 1990s newer antibiotics of the erythromycin group have been introduced. One of these, clarithromycin, may offer advantages over erythromycin in the treatment of difficult respiratory tract infections.