Search PubMed⌕ Search

Biomedical subjects

B Workman

Publications and source records attributed to B Workman.

8 recordsLinked to original sources
PubMed1997

Halothane hepatitis in a South African population--frequency and the influence of gender and ethnicity.

AIM: To review post-anaesthetic hepatitis in a South African population, given that halothane use is restricted in other countries because of the high mortality and morbidity of its associated type II (idiosyncratic) hepatitis, even though it is still widely used in South Africa. STUDY DESIGN: Descriptive, retrospective analysis. PATIENTS AND METHODS: Hepatitis cases that occurred after inhalational anaesthetic use were identified by means of a computer search of Groote Schuur Hospital records, 1980-1994. Cases of hepatitis caused by circulatory failure and viral hepatitis were excluded. RESULTS: Twenty-six episodes occurred in 22 patients (mean age 49.05 years, range 32-65 years), of whom 15 were women. This gave an estimated incidence of 3.53/100,000 anaesthetics (95% confidence interval 2.06-5.0/100,000). All had pyrexia (mean 38.7 +/- 0.72 degrees C), malaise, anorexia or nausea and vomiting, with onset a mean of 4.27 +/- 3.5 days after exposure. Jaundice occurred in 86%, rash in 13.6%; 17 patients (77%) were obese. Alanine and aspartate aminotransferase levels were raised 47.49 +/- 61.8 and 55.9 +/- 54.5 times the upper limit of normal. Seven patients died and 1 underwent liver transplantation. Hepatitis occurred after the first exposure in only 2 patients (9%). Men and women had a similar risk, but the estimated relative risk for whites v. black or coloured patients was 3.33 (95% confidence interval 1.45-7.23; P = 0.003) controlling for gender. Awareness of the condition was suboptimal, and in 3 patients re-exposure to halothane occurred after an initial episode of typical halothane hepatitis. CONCLUSION: Halothane hepatitis remains a major cause of morbidity and mortality in South Africa. It is more common in whites, but there was no gender-related excess risk.

Adult↗
PubMed1994

Fluoxetine induced dyskinesia.

A case of fluoxetine induced dyskinesia in an elderly woman with previous use of low dose haloperidol is described. In contrast to neuroleptic induced tardive dyskinesia it was characterised by a rapid onset after commencing fluoxetine and rapid resolution on cessation. In the case discussion we describe other cases of fluoxetine induced extrapyramidal syndromes and possible mechanisms.

Aged↗
PubMed1992

Comparison of the pharmacokinetics and pharmacodynamics of perindopril, cilazapril and enalapril.

1. The pharmacokinetic and pharmacodynamic responses to enalapril, perindopril and cilazapril have been studied in essential hypertensives (2, 4 and 8 mg perindopril and 2.5 mg cilazapril, single dose and steady state) and normotensive volunteers (10 mg enalapril, single dose). 2. Plasma levels of the active diacid compounds reached similar peaks after single dose administration of the drugs. However, perindoprilat levels persisted for 5 days whereas cilazaprilat levels were not detectable beyond 12 h. 3. The higher levels of perindoprilat were associated with a greater inhibition of plasma angiotensin-converting enzyme (ACE) activity in both acute and steady state studies. 4. The potency of the active diacids in inhibiting plasma ACE activity was perindoprilat greater than cilazaprilat greater than enalaprilat. 5. There was a close relationship between plasma concentration, ACE inhibition and blood pressure decrease. Although both cilazapril and perindopril administration reduced blood pressure in hypertensive subjects, only perindopril exerted 24 h blood pressure control at the doses used.

Adult↗
PubMed1987

Comparison of pharmacokinetics and pharmacodynamics of adrenoceptor agonists and antagonists as antihypertensive agents.

Central and peripheral alpha-adrenoceptors play an important role in cardiovascular regulation, and selective alpha 1-adrenoceptor antagonists and alpha 2-adrenoceptor agonists have an established place in the therapy of hypertension. Prazosin is a selective alpha 1-antagonist that is both effective in lowering blood pressure and well tolerated. However, the more recently developed alpha 1-antagonists doxazosin and terazosin offer the advantage of having longer half-lives, allowing once daily administration. Clonidine is a centrally acting alpha 2-agonist whose clinical use has often been limited by the dose dependent side effects of dry mouth and sedation, and the belief that it should be given three times per day. However, recent studies have shown that it has substantial antihypertensive efficacy with minimal side effects at low doses, and that half-life is long enough to allow twice daily administration. An improved understanding of the pharmacodynamics and pharmacokinetics of drugs acting on alpha-adrenoceptors allows a more rational approach to their clinical application.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Enhancing the nursing role: why nurses want to cannulate.

This small qualitative study explored nurses' reasons for undertaking a traditional medical task, that of peripheral intravenous cannulation, and their perceptions as to how this task contributes to their nursing skills. The findings suggest that it benefits the continuity and quality of patient care and provides nurses with personal and professional satisfaction, promoting the delivery of holistic care and the opportunity to initiate autonomous clinical interventions. It is argued that the development of such nursing skills may require professional and organizational support in the form of practice guidelines, protocols and vicarious liability boundaries to enable nurses to practise effectively and efficiently.

Attitude of Health Personnel↗
PubMedDate not supplied

Peripheral intravenous therapy management.

Many nurses are involved in the management of peripheral intravenous therapy. Using scenarios of common presenting problems and evidence-based interventions, this article describes rationales for best practice. Readers are encouraged to critically appraise their own practice and to consider ways to improve the standard of intravenous therapy in their clinical area.

Benchmarking↗
PubMedDate not supplied

Nephrotic syndrome.

Explore the source record for details and available documents.

Adult↗