Biomedical subjects

C A Sorkness

Publications and source records attributed to C A Sorkness.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Effect of polymorphism of the beta(2)-adrenergic receptor on response to regular use of albuterol in asthma.

BACKGROUND: Regular use of inhaled beta-adrenergic agonists may have adverse effects in some asthma patients. Polymorphisms of the beta(2)-adrenergic receptor (beta(2)-AR) can affect its regulation; however, results of smaller studies of the effects of such polymorphisms on response to beta-agonist therapy have been inconsistent. METHODS: We examined the possible effects of polymorphisms at codons 16 (beta(2)-AR-16) and 27 (beta(2)-AR-27) on response to albuterol by genotyping 190 asthmatics who had participated in a trial of regular versus as-needed albuterol use. RESULTS: During the 16-week treatment period, patients homozygous for arginine (Arg/Arg) at beta(2)-AR-16 who used albuterol regularly had a small decline in morning peak expiratory flow (AM PEF). This effect was magnified during a 4-week run-out period, when all patients returned to as-needed albuterol only. By the end of the study, Arg/Arg subjects who had used albuterol regularly had an AM PEF 30.5 +/- 12.1 liters/min lower (p = 0.012) than Arg/Arg patients who had used albuterol as needed only. Subjects homozygous for glycine at beta(2)-AR-16 showed no such decline. Evening PEF also declined in the Arg/Arg regular but not in as-need albuterol users. No significant differences between regular and as-needed treatment were associated with polymorphisms at beta(2)-AR-27. CONCLUSIONS: Polymorphisms of the beta(2)-AR may influence airway responses to regular inhaled beta-agonist treatment.

Adolescent↗

PubMedDate not supplied

Analgesia with oral narcotics and added ibuprofen in cancer patients.

A scheduled regimen of oral narcotic analgesics was compared with a regimen of oral narcotic analgesics plus ibuprofen for analgesic efficacy in patients with cancer. Ten patients with metastatic cancer were randomly assigned to receive either ibuprofen 400 mg or a look-alike placebo four times daily in addition to each patient's existing regimen of scheduled oral narcotics. A two-period changeover study design was used. The 24-hour narcotic intake equated to injectable morphine was computed for each patient at baseline and during the nine study days. A visual analogue scale was used to evaluate pain relief, nausea, mood depression, daytime drowsiness and nighttime sleeplessness. The analgesic efficacy of the narcotic-ibuprofen combination was significantly greater than the analgesic efficacy of the narcotic-placebo combination. Eight patients demonstrated a positive treatment effect with added ibuprofen; the overall improvement in analgesia averaged 39.1% in these patients. There was no significant increase from baseline in the incidence of nausea, mood depression, daytime drowsiness or nighttime sleeplessness. At the doses used in this study, a treatment regimen of oral narcotic analgesics plus ibuprofen was more effective than oral narcotics alone in relieving pain associated with cancer.

Administration, Oral↗

PubMedDate not supplied

The use of 5-lipoxygenase inhibitors and leukotriene receptor antagonists in the treatment of chronic asthma.

With the elucidation of asthma as a chronic inflammatory disease, therapeutic approaches have shifted from treatment of symptoms with bronchodilators to treatment of the underlying disease with antiinflammatory agents. Along with concerns about corticosteroid side effects on the part of both physicians and patients, this shift has motivated researchers to develop and test new agents with antiinflammatory capabilities. The leukotrienes are endogenous mediators with three inflammatory effects: they increase vascular permeability, recruit other inflammatory leukocytes, and induce bronchoconstriction. A number of antileukotriene agents are in various stages of development. Zileuton, a leukotriene synthesis inhibitor, has been shown to improve airway function and reduce asthma-symptoms, although there is some concern over liver toxicity. Zafirlukast, montelukast, and pranlukast, three new leukotriene receptor antagonists, have similar benefits and have not been associated with serious increases in liver enzymes. It is hoped that new antiinflammatory drugs will provide clinicians with targeted and effective asthma treatments that do not bear the potential risks of corticosteroid therapy.

Asthma↗