Search PubMed⌕ Search

Biomedical subjects

C D Ponte

Publications and source records attributed to C D Ponte.

At least 19 recordsLinked to original sources
PubMed1995

Acute pulmonary edema associated with ocular metipranolol use.

OBJECTIVE: To report a case of pulmonary edema associated with the use of ocular metipranolol, a nonselective beta-blocker. CASE SUMMARY: A 72-year-old woman with no history of pulmonary or cardiac disease presented to the emergency room with signs and symptoms consistent with cardiogenic pulmonary edema. The patient had used metipranolol eyedrops approximately 1 hour before becoming symptomatic. When rechallenged inadvertently while hospitalized, the patient again became symptomatic. The patient's metipranolol eyedrops then were substituted with betaxolol eyedrops. She continued to be free of symptoms of pulmonary edema at subsequent clinic visits 1, 4, and 6 weeks following discharge. DISCUSSION: This is the first reported case of pulmonary edema associated with metipranolol. There was a reasonable temporal association between use of the eyedrops and the onset of symptoms. Beta-blockers may cause cardiogenic pulmonary edema secondary to their negative inotropic and negative chronotropic effects. The drug's lipid solubility or a deficiency in the enzyme responsible for its metabolism may have allowed the drug to accumulate to a critical concentration over the 6-week period of use. CONCLUSIONS: Ocular beta-blockers must be used with caution in patients with relative contraindications to beta-blockade. This case illustrates that these agents must be used prudently even in patients with no history of symptomatic congestive heart failure.

Aged↗
PubMed1994

Suspected trimethoprim/sulfamethoxazole-induced hypoprothrombinemia.

The following report illustrates a case of trimethoprim/sulfamethoxazole-induced hypoprothrombinemia in a patient receiving ongoing warfarin therapy for atrial fibrillation and aortic valve replacement. He was treated with trimethoprim/sulfamethoxazole (TMP/SMX) for sinusitis. During this time, the patient's prothrombin time international normalized ratio (INR) increased 3.5 times higher than the baseline value. The INR values decreased when the antibiotic was discontinued. If a patient is on warfarin and TMP/SMX is added, INR values should be monitored closely.

Aged↗
PubMed1992

Monitoring diabetes mellitus: the pharmacist's role.

The pharmacist is in a unique position to monitor and counsel the patient with diabetes mellitus. Providing these services requires familiarity with both the disease and its contemporary management. Pharmacists can provide the necessary counseling and guidance regarding the myriad products and devices available to the patient and can serve as a resource to the physician and other health care professionals. Pharmacists with a special interest in diabetes are encouraged to develop services that are compatible with their practice resources. This shared-care approach to treatment will help contribute to the goal of a normal lifestyle for the person with diabetes mellitus.

Blood Glucose Self-Monitoring↗
PubMed1992

Septic discitis resulting from Escherichia coli urosepsis.

Septic discitis refers to a primary suppurative process involving the intervertebral disc space and occurs as a result of hematogenous invasion or contamination by pyogenic organisms. A case of septic discitis is described in a 77-year-old woman following an episode of Escherichia coli urosepsis. Despite bed rest, an orthosis, and appropriate antibiotics, the patient ultimately had to undergo surgical disc removal. The diagnosis of septic discitis is often made in the context of other diseases that share common clinical and laboratory findings. Magnetic resonance imaging appears well suited for diagnostic confirmation of septic discitis. Needle biopsy and aspiration results should be used to determine the appropriate choice of antibiotic for this disease process.

Aged↗
PubMed1990

A suspected case of trimethoprim/sulfonamide-induced localized exfoliation.

A variety of skin reactions have been associated with the use of sulfonamides. Most of the reactions are uneventful and abate with drug discontinuation. Rare but severe skin reactions can occur and include the Stevens-Johnson syndrome and exfoliative dermatitis. Dermal reactions appear to be the most commonly reported adverse effect in children. Drug continuance following the development of a mild skin rash may be associated with the development of a more severe dermal reaction. This report summarizes a case involving a six-year-old white girl who developed exfoliative dermatitis confined to the feet following a course of oral trimethoprim/sulfamethoxazole (TMP/SMX) for otitis media. Exfoliation is an uncommon cutaneous manifestation following sulfonamide use. Although usually a generalized process, it is unusual to find it confined to the feet. Unfortunately there is no useful diagnostic method that could specifically elucidate the cause of a dermatologic eruption. Available evidence suggest that TMP/SMX was the probable cause of our patient's rash. Adjunctive antihistamines and corticosteroids are often useful when pruritus is present. Severe reactions require vigorous supportive treatment.

Child↗
PubMed1990

The clinical use of oral sulfonylureas in the management of non-insulin dependent diabetes mellitus (NIDDM).

Eighty percent of Americans afflicted with diabetes mellitus have Type II or non-insulin dependent diabetes mellitus (NIDDM). Impaired or defective insulin secretion and insulin resistance are universal pathophysiologic findings. Management involves attention to diet, exercise, and commonly the use of insulin and/or oral sulfonylureas. Currently there are six marketed first and second generation agents available for use in the United States. Although the newer agents are more potent, they all share a similar mechanism of action. These agents can only be effective if the patient has retained beta cell secretory function. Pharmacokinetic and pharmacodynamic differences may make the newer agents, glyburide and glipizide, preferred in the management of Type II diabetes mellitus. The combined use of insulin and oral sulfonylureas may be useful for the patient exhibiting persistent fasting hyperglycemia despite maximal oral drug therapy. The precise role for combination therapy and optimal patient characteristics awaits further study.

Administration, Oral↗
PubMed1989

Heinz-body hemolytic anemia associated with phenazopyridine and sulfonamide.

A 27-year-old white woman developed Heinz-body hemolytic anemia following multiple courses of oral phenazopyridine and trimethoprim-sulfamethoxazole. Her diagnosis was supported by the finding of bite cells on peripheral blood smear. The patient's rapid recovery and reversal of abnormal laboratory parameters were consistent with an acquired hemolytic disorder. This case should sensitize the clinician to the development of drug-induced oxidative hemolysis, its clinical features, and its reversibility. It is also important that the clinician recognize those drugs capable of causing this disorder and appreciate the methods available to establish the diagnosis.

Administration, Oral↗
PubMed1989

Estrogen replacement therapy: a pilot survey of primary care physicians in West Virginia.

Controversy surrounds the optimal use of estrogen replacement therapy (ERT) for the management of vasomotor instability and other perimenopausal symptoms. This fact and the obvious lack of published literature regarding physician prescribing behavior led the investigators to explore these issues with primary care physicians in West Virginia. Data were collected using a mailed, self-administered questionnaire. Issues addressed included reasons for using/not using ERT, patient symptoms, type of therapy prescribed, treatment duration, and symptom resolution or rebound. Approximately 25 percent of the 420 physicians contacted responded to the questionnaire. The overwhelming majority prescribes ERT for their patients. Most physicians prescribe an estrogen/progesterone combination for some or all patients, depending on the clinical situation. Conjugated estrogens in physiologic doses and synthetic progestins are most frequently prescribed and administered on a cyclic basis. Most women prescribed ERT experienced symptom resolution. Treatment outcome was not correlated with treatment duration.

Adult↗