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Biomedical subjects

B L Carter

Publications and source records attributed to B L Carter.

185 records · Page 11Linked to original sources
PubMedDate not supplied

Effects of pravastatin on plasma lipid concentrations in poloxamer 407-induced hyperlipidemic rats.

A new animal model of hyperlipidemia is being developed using the nonionic surfactant poloxamer 407 (P-407). We investigated the impact of pravastatin on P-407-induced hyperlipidemia. Twenty rats received P-407 300 mg intraperitoneally to induce hyperlipidemia, and 20 control rats received saline injection. Pravastatin was administered orally to an equal number of rats in both groups using three different regimens. A fourth group did not receive pravastatin. At 24 hours after injection, total cholesterol levels in two of the pravastatin groups were 28% and 34% lower than those in animals that did not receive pravastatin (p < or = 0.01). At 48 hours, triglyceride levels were significantly lower in all pravastatin groups (21-44%) versus animals not receiving pravastatin. Pravastatin diminished the effects of P-407 on lipoproteins. This new animal model may be useful in screening for investigational antihyperlipidemic agents.

Animals↗
PubMedDate not supplied

Differences in serum concentrations of and responses to generic verapamil in the elderly.

STUDY OBJECTIVE: To determine if there are greater differences in bioavailability of generic verapamil at steady state in elderly patients than in healthy young subjects. DESIGN: Double-blind, randomized, three-way crossover study. SETTING: Clinical research center at a general teaching hospital. SUBJECTS: Eight young, healthy subjects between ages 18 and 45 years, and eight elderly, hypertensive patients over 65 years of age. INTERVENTIONS: Each participant was randomly assigned to receive brand-name verapamil or one of two generic preparations. Young subjects received each of the three preparations 80 mg twice/day for 7 days separated by a 1-week washout. Elderly patients took the three preparations for 21 days. Serum drug levels and blood pressure were measured and electrocardiograms performed 13 times after the last dose of drug. MAIN RESULTS: In young subjects, the pharmacokinetics and pharmacodynamics of the three preparations were nearly identical. There was, however, a great deal of variability in the bioavailability of the generic products. In the elderly patients, one generic product had a maximum serum concentration and area under the curve that were 77% and 43% greater, respectively, than the brand-name product (p < 0.02). Assessments of bioequivalency (based on confidence intervals) demonstrated that this generic drug's bioavailability was from 4-118% and peak serum concentration from 10-139% greater than the brand-name drug. This was associated with greater prolongation of the PR intervals. CONCLUSIONS: A generic verapamil product that is bioequivalent in young subjects may not be bioequivalent in elderly subjects. Testing of drugs with complex pharmacokinetics in young subjects may not reliably predict the clinical outcomes in elderly hypertensive patients.

Adult↗
PubMedDate not supplied

Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting.

We evaluated blood pressure control, quality of life, quality of care, and satisfaction of patients who were monitored by specially trained community pharmacists in a group medical practice. After participating in an intensive skill development program, pharmacists performed in an interdisciplinary team in a rural clinic. The primary objective was assessed by evaluating outcome variables at 6 months compared with baseline in 25 patients randomly assigned to a study group. A control group of 26 patients was also evaluated to determine if outcome variables remained constant from baseline to 6 months. Systolic blood pressure was reduced in the study group (151 mm Hg baseline, 140 mm Hg at 6 mo, p<0.001) and diastolic blood pressure was significantly lower at 2, 4, and 5 months compared with baseline. Ratings from a blinded peer review panel indicated significant improvement in the appropriateness of the blood pressure regimen, going from 8.7 +/- 4.7 to 10.9 +/- 4.5 in the study group (p<0.01), but they did not change in the control group. Several quality of life scores improved significantly in the study group after 6 months (p<0.05). These included physical functioning (61.6 vs 70.7), physical role limitations (56.8 vs 72.8), and bodily pain (60.0 vs 71.7) at baseline and 6 months, respectively. There were no significant changes in the control group. Patient satisfaction scores were consistently higher in the study group at the end of the study. Our results indicate that when community pharmacists in a clinic setting are trained and included as members of the primary care team, significant improvements in blood pressure control, quality of life, and patient satisfaction can be achieved.

Adult↗