Probable resistance to vecuronium involving the 17-hydroxy metabolite.
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Biomedical subjects
Publications and source records attributed to D A Cozanitis.
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Following control observations of intraocular pressure and pupil size, in doses suitable for pre-anaesthetic medication, glycopyrrolate (0.004 mg/kg) and atropine (0.01 mg/kg) were given intramuscularly to healthy volunteers in a randomised, cross-over fashion. No significant change in either intraocular pressure or pupil size was noted 45 min after drug administration.
Intermittent doses of suxamethonium have been known to result in bradycardia changes in cardiac rhythm. In order to assess the efficacy of a newer quaternary ammonium antimuscarinic, glycopyrrolate, on the cardia effects of intermittent suxamethonium, 28 patients received this drug intravenously just before induction of anesthesia. For comparison, 28 other patients were given atropine. In the atropine series, three patients developed bradycardia while none of those of the glycopyrrolate series did so. In addition, more patients had cardiac arrhythmias in the atropine group. Although no statistically significant differences were seen, clinically, glycopyrrolate seems to afford better protection against the cardiac changes resulting from intermittently administered suxamethonium.
Pathogenic and potentially pathogenic bacteria were found on telephones of an intensive care unit. Direct contamination by microorganisms from throats, hands, and noses of the staff members is real although airborne contamination would also play a role. The awareness of environmental risk in intensive care units is underlined.
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The potency ratio of galanthamine and neostigmine was studied on the rat phrenic nerve-diaphragm preparation. This ratio appeared to be about 18 on a weight base. The potency ratio in man in vivo, is about 20. Hence we concluded that this potency ratio might mainly be due to the difference in potency on the neuromuscular transmission and not to kinetic differences.
Galanthamine hydrobromide, an anticholinesterase drug capable of penetrating the blood-brain barrier, was used in a patient demonstrating central effects of scopolamine (hyoscine) overdosage. It is longer acting than physostigmine and is used in anaesthesia to reverse the non-depolarizing neuromuscular block. However, studies into the dose necessary to combating scopolamine intoxication are indicated.
Bacteria in the hair of staff members and patients of the Intensive Care Unit were studied. Pathogenic organisms were isolated in both groups indicating possible dangers and the need for the awareness of hair as a carrier of bacteria is stressed.
Following pneumonectomy, it is usual to see a degree of mediastinal displacement in the direction of the empty cavity. In the present case however, the displacement was towards the sound side. Description and management of this situation is presented.