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Biomedical subjects

E Elonen

Publications and source records attributed to E Elonen.

102 records · Page 6Linked to original sources

Comparative effect of food on absorption of ampicillin and pivampicillin.

The effect of food on the absorption of simultaneously ingested ampicillin or pivampicillin was compared in a crossover study in eight healthy volunteers. The absorption of both ampicillin and pivampicillin was delayed by simultaneous food intake as judged by serum concentration and urinary excretion of ampicillin. The total absorption of ampicillin, but not that of pivampicillin was decreased by simultaneous food intake as indicated by the are under the serum ampicillin concentration-time curves and by 24 hours urinary excretion of ampicillin. The excretion of ampicillin into urine was about 30% of the dose when ampicillin was ingested with water into an empty stomach and about 20% when ingested with food. The respective excretion of ampicillin following the ingestion of pivampicillin was about 60% of the dose taken either with or without food.

Adult↗

Effect of tricyclic antidepressants and alcohol in psychomotor skills related to driving.

Twenty healthy subjects took amitriptyline, doxepin, and placebo for 2 wk each in a double-blind crossover trial, and another 20 subjects similarly took nortriptyline, chlorimipramine, and placebo. The antidepressants were given three times daily in doses generally used for neurotic patients. The presence of antidepressants in tissues was checked with the tyramine pressor test. On the seventh and fourteenth days of each period, psychomotor skills (choice reaction, coordination, and attention) were measured after the administration of drugs in combination with an alcoholic or placebo drink. Dose-response graphs for the tyramine pressor effect were shifted to the right during the antidepressant treatment, indicating a blockade of the membrane pump in peripheral sympathetic terminals. This antityramine effect of antidepressants did not correlate with their psychomotor effects. No drug alone importantly impaired psychomotor skills. Amitriptyline in combination with alcohol increased cumulative choice reaction times, and doxepin in combination with alcohol increased both cumulative choice reaction times and inaccuracy of reactions. Coordination was impaired after both of these combinations on the seventh day. It seems as if doxepin and amitriptyline but not nortiriptyline or chlorimipramine, in combination with 0.5 gm/kg of alcohol, may be especially dangerous in driving.

Adult↗

Cardiovascular effects of amitriptyline, nortriptyline, protriptyline, and doxepin in conscious rabbits after subacute pretreatment with protriptyline.

Conscious rabbits which had been permanently catheterized into their aortas and posterior caval veins, were injected daily with 10 mg/kg of protriptyline subcutaneously, divided in 3 doses. The blockade of the membrane pump in sympathetic nerve terminals by protriptyline was checked by pressor tests with noradrenaline (NA) and tyramine. In the presence of the membrane pump blockade 2.5 mg/kg of amitriptyline, nortriptyline, or protriptyline, or 3.0 mg/kg of doxepin was injected i.v. The antidepressants lowered blood pressure transiently and increased the heart rate, doxepin and amitriptyline being more effective than nortriptyline and protriptyline. Amitriptyline and doxepin provoked more severe cardiac arrhythmias on ECG than nortriptyline, and protriptyline caused no arrhythmias. Intravenous infusion of NA (11 mug/min) raised the blood pressure and lowered the heart rate. Injection of antidepressants during NA infusion resulted in more pronounced depressor and tachycardic effects than occurred without NA infusion. Major ECG changes were only slightly more apparent than without NA infusion. The rank order of toxicity of the antidepressants was the same. It is concluded that the NA potentiation by tricyclic antidepressants is not the main reason for their cardiotoxic effects.

Amitriptyline↗

Effect of beta-adrenoceptor blocking drugs, physostigmine, and atropine on the toxicity of doxepin in mice.

Large doses of doxepin given intravenously to animals cause tachyarrhythmias, and still higher doses lead to a progressive and, finally, lethal bradycardia. The effect of pretreatment with five different beta-adrenoceptor blocking drugs (propranolol, alprenolol, practolol, metoprolol or tolamolol), p physostigmine, or atropine on these toxic actions of doxepin was investigated. Mice were sedated with diazepam. Doxepin was injected i.v. 0.1 mg every 15 sec until death. ECG was recorded at 10 sec after every injection. All five beta-blockers injected i.p. 30 min before doxepin inhibited the doxepin-induced tachyarrhythmias. None of the drugs prevented or postponed the death of mice. Large doses of beta-blockers dose-dependently enhanced the doxepin-induced bradycardia and accelerated death. The cardioselective beta-blocking drugs practolol and metoprolol proved less active in enhancing bradycardia than the third cardio-selective drug, tolamolol, and non-selective propranolol and alprenolol. This difference may have resulted from properties other than beta-blockade since practolol and metoprolol lack the "cardiodepressant" and local anaesthetic properties. Since physostigmine and atropine did not modify the doxepin effects the anticholinergic property may not be important in the severe cardiotoxic effects of doxepin.

Adrenergic beta-Antagonists↗

Etoposide, 6-thioguanine and idarubicin, an oral combination regimen (ETI) for the induction treatment of acute leukemia.

Twenty patients with advanced acute leukemia (16 acute myeloid leukemia (AML), three myeloid blast crisis (BC) of chronic myeloid leukemia (CML), one acute lymphatic leukemia) were treated with a peroral regimen consisting of etoposide 80 mg/m2 and 6-thioguanine 100 mg/m2 twice daily for 5 days, and idarubicin 15 mg/m2 once daily for 3 days (ETI). Two AML patients were in first relapse. All the other patients with acute leukemia had a later relapse or were refractory to primary or salvage treatment. One to six ETI cycles were given. Four AML patients achieved remission and one patient with BC of CML entered the second chronic phase. Clearing of the blood of leukemic cells was seen in seven additional patients. Infection was the most common complication, gastrointestinal toxicity was not a major problem. In conclusion, peroral ETI treatment has a marked antileukemic effect even in an advanced disease, and the toxicity is moderate and well acceptable.

Administration, Oral↗

Prospective study on humoral immune response induced by fungal infection in patients with hematologic malignancies.

To evaluate the immune response in an immunosuppressed population, antibodies against commercially available Candida albicans antigens were prospectively studied during 37 episodes of acute stomatitis caused by C. albicans and 36 episodes complicated by deep-seated mycoses in 62 adult patients with hematologic malignancies. During uncomplicated stomatitis in patients with acute leukemia, the mean peak IgM, IgG and IgA class enzyme-linked immunosorbent assay (ELISA) units differed significantly from the basic level preceding fungal infection. Mean time until peak values was 2.7-3.8 weeks after diagnosis of stomatitis. During systemic mycoses the antibody response was similar. Among patients with other hematologic malignancies, predominantly lymphomas, several were terminally ill and responded infrequently by antibody production. Similar results were given by Ouchterlony immunodiffusion and counterimmunoelectrophoresis. Thus, patients with acute leukemia showed an antibody response to fungal infection; the peak values, however, were somewhat delayed.

Adolescent↗

Serial study of C-reactive protein during fungal esophagitis and enterocolitis.

C-reactive protein (CRP) responses were followed in weekly serum samples in the course of eight episodes of esophagitis (37 sera) and ten episodes of enterocolitis (45 sera) caused by Candida albicans in an equal number of patients with hematologic malignancies under antibacterial medication. During fungal esophagitis CRP was elevated, with peak values ranging from 73 to 380 mg/l (mean +/- SD: 170 +/- 104 mg/l). The same was true for fungal enterocolitis, with the peak values ranging from 54 to 225 mg/l (mean +/- SD: 146 +/- 56 mg/l). In both these conditions, antimycotic treatment was followed by clinical improvement, reduced or eliminated fungal growth and falling levels of CRP, occasionally down to the normal value (less than 6 mg/l). Thus, follow-up of CRP level is useful as an aid in the diagnosis of gastrointestinal candidosis and in evaluating its treatment.

Adult↗

Percutaneous drainage of periappendiceal abscess in a patient with acute leukemia. Case report.

In a 24-year-old man with acute lymphatic leukemia, acute appendicitis after induction of chemotherapy led, with minimal clinical signs, to perforation and periappendiceal abscess (verified with CT and US-guided needle aspiration). Percutaneous drainage was performed for 11 days and appendectomy 3 days later. Recovery was uncomplicated and cytostatic therapy was resumed.

Abscess↗