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Biomedical subjects

A Mathews

Publications and source records attributed to A Mathews.

At least 37 records · Page 2Linked to original sources
PubMed1988

Quantitative and qualitative assessment of serum concentration monitoring and dosage adjustment of aminoglycosides.

A prospective study was carried out in 50 adult patients to determine the extent and quality of aminoglycoside serum concentration monitoring and dosage adjustment in a U.K. teaching hospital. Data were collected concerning prescription details, assay results, and subsequent dosage adjustment, methods of dosage determination, and timing of samples. Thirty-three patients received aminoglycosides without a positive culture. The mean +/- SD initial doses were 1.75 +/- 0.45 mg/kg for gentamicin and 2.33 +/- 0.55 mg/kg for netilmicin. Doses were derived from physicians' personal experience for 35 patients and using nomograms for 11 patients. Prescribed and actual administration times were observed on 218 occasions. The difference between these times were significantly different (p less than 0.005). Fifty-six trough, 61 peak, and 61 random assays were carried out, of which 48% of troughs and 56% of peaks were in the therapeutic range. Dosage regimens were calculated based on actual serum concentration assay results using the Sawchuk-Zaske method. These calculated doses were compared to actual prescribed doses for each patient. The calculated doses were greater than 120% of the prescribed doses in 78% of patients. There was a significant tendency to underdose (p = 0.001). It is concluded that the service might benefit from an individualised approach to dosage determination.

Adolescent↗
PubMed1987

Clinical pharmacokinetics, toxicity and cost effectiveness analysis of aminoglycosides and aminoglycoside dosing services.

This article reviews the clinical pharmacokinetics, clinical toxicity and cost-effectiveness analysis of aminoglycosides and of dosing services for aminoglycosides. The reader is referred elsewhere for a review of the pharmacology, antimicrobial spectrum of activity and clinical use of these drugs. A critique of the more commonly used methods of aminoglycoside dosage determinations is included, based on the inter-individual variation in aminoglycoside disposition parameters. The advantages and disadvantages of arbitrary, predictive, and pharmacokinetic methods of dosing determination are summarized. Justification for the routine determination of serum aminoglycoside concentrations is reviewed. We review the lack of standardization of definitions for aminoglycoside-associated nephrotoxicity in published studies, and studies which illustrate these differences are highlighted. Evidence for the association between serum aminoglycoside concentrations and nephrotoxicity is examined. Ototoxicity is similarly reviewed. The concept of cost-effectiveness analysis is examined extensively in this review. We discuss the literature concerning the cost benefit analysis of drug dosing services.

Amikacin↗
PubMed1987

Is aminoglycoside-associated nephrotoxicity uncommon in the U.K?

Fifty adult patients who were treated with aminoglycosides (AG) were studied prospectively. All patients were assessed by the investigators for AG-associated nephrotoxicity using criteria as defined by each prescriber, compared to a standard published set of criteria. The prescribers stated that none of the patients suffered toxicity using their criteria. Thirteen patients (26%) suffered toxicity using the published criteria. No patients were dosed on a pharmacokinetic basis. All patients with toxicity had trough levels greater than 2.0 mg/l, and those six patients with severe toxicity also had peak levels greater than 10.0 mg/l. It is suggested that prescribers in the U.K. may not be as familiar or concerned with AG dosing methods and nephrotoxicity as their U.S. counterparts.

Adolescent↗
PubMed1987

Perception of emotionally valenced information in depression.

Bower's (1981) associative network model of mood and cognition predicts that depression will selectively facilitate the perception of negatively toned words. Recent studies by Clark et al. (1983) and by Powell & Hemsley (1984) have, however, produced apparently discrepant results. Alternative means of accommodating the discrepancy are considered, and the current experiment empirically distinguishes between these possibilities. The results are inconsistent with Bower's model.

Adult↗
PubMed1986

Factors related to successful outcome in the treatment of sexually unresponsive women.

Couples in whom the main complaint was of a lack of female sexual response were treated using a practical counselling approach. A number of pre-treatment measures were studied to determine which factors were predictive of treatment outcome. While age and chronicity were not predictive, the quality of the general relationship and measures of sexual attitude did give useful indications of likely outcome.

Adult↗