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Biomedical subjects

F D Thompson

Publications and source records attributed to F D Thompson.

34 records · Page 2Linked to original sources

Clinical use of minoxidil (Loniten).

The powerful peripheral vasodilator minoxidil, in a dose of 5-40 mg daily, controlled the previously refractory blood pressure in 45 out of 47 patients for periods up to fifty-seven months. The majority of the previous polypharmacy was withdrawn, leaving most of the patients taking a beta-blocking drug, minoxidil and a diuretic. Severe sodium retention leading to congestive cardiac failure necessitated the withdrawal of the drug in 3 patients. In one patient the drug was discontinued because of postural hypotension, and it was withdrawn in 2 female patients because of hirsutism. Five patients were removed from the trial as they were started on chronic maintenance haemodialysis or received a renal transplant. Significant glucose intolerance developed in one patient, requiring the addition of an oral hypoglycaemic agent. The 4 deaths that occurred were not directly related to treatment. Following the oral administration of 5 mg minoxidil, an obvious reduction in both the systolic and diastolic pressure was seen in two hours.

Adolescent↗

An outbreak of Nocardia asteroides infection in a renal transplant unit.

An outbreak of Nocardia asteroides infection occurred in the nephro-urological intensive care unit, St. Peter's Group of Hospitals, London in 1979. In is suggested that the outbreak has been due to patient-to-patient transmission. Five months before the outbreak. N. asteroides was first isolated from nephrostomy urine from an asymptomatic patient who had undergone several urological operations. Subsequently six of the seven patients admitted for renal transplant over a three month period developed proven infections. The first transplant patient had an abdominal abscess and the other five had only pulmonary disease with obvious radiological lesions. Bacteriological diagnosis was made in three patients by examination of sputum and in the other three from bronchoscopic specimen, pleural fluid and pus from an abscess respectively. Five of the six renal transplant patients were treated with amoxycillin and erythromycin. Clinical and radiological improvement was observed and no patient died as a result of the infection. In the intensive care unit air and dust samplings were positive for N. Asteroides. The unit was closed and fumigated with formaldehyde and when the air sampling continued to be negative the unit was then re-opened.

Adult↗

Single sample estimates of renal clearances.

Thirty adult patients were investigated with 36 125I Hippuran and 40 51Cr EDTA single injection clearance studies. "Volumes of distribution" obtained from single samples have been correlated with the slope clearances and regression equations have been determined. From these equations it is possible to determine glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) from single plasma samples and the method is sufficiently accurate for routine application.

Adult↗

Hyponatraemia.

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Extracellular Space↗

Monotherapy with labetalol for hypertensive patients with normal and impaired renal function.

1 Labetalol was given to 41 hypertensive patients in a divided dosage of 150--2,400 mg daily for periods ranging from 1--64 months. 2 Monotherapy with labetalol was adequate in 12 out of 19 patients with essential hypertension and in 15 out of the 22 with renal hypertension. 3 Following a single dose of labetalol 200 mg orally a hypotensive response was seen between 1.5 and 2 hours. 4 In the doses used there was no exercise or postural hypotension. 5 No reduction in overall renal function attributable to labetalol was seen.

Blood Pressure↗

Acute haemodynamic effects of labetalol and its subsequent use of an oral hypotensive agent.

1 Fourteen patients whose lying diastolic blood pressure was persistently 110 mmHg or greater were given labetalol 0.5--1 mg/kg intravenously. 2 The maximum hypotensive effect developed between 20 and 40 min, and on average lasted 3 h. The lying systolic mean blood pressure fell by 30 mmHg and the lying diastolic blood pressure by 17 mmHg (P less than 0.001). 3 This acute hypotensive effect was associated with a significant reduction in the peripheral resistance (P less than 0.02). The hypotension was not associated with significant secondary changes in the stroke volume or pulse rate. 4 The above 14 patients plus 1 additional subject received labetalol orally at a daily dose ranging from 150-2400 mg. The mean lying systolic blood pressure fell by 22 mmHg (P less than0.01) and the mean lying diastolic blood pressure by 26 mmHg (P less than 0.001). The standing values were similar and postural hypotension at this dose did not develop. There was no significant change in the pulse rate. 5 Renal function was monitored by estimates of plasma creatinine and creatinine clearance. Some patients were followed for 2 yr and others for a few months. With the long-term patients, there was no significant reduction in either measurement although in a few patients a slight reduction in creatinine clearance was observed.

Administration, Oral↗

Pharmacodynamics of propranolol in renal failure.

The pharmacodynamics of propranolol were studied in patients with renal functional impairment. (14)C-labelled propranolol was given either intravenously or by mouth and the disappearance rates of propranolol, 4-hydroxypropranolol, and total radioactive metabolites measured. The renal clearance of total radioactive compounds is directly related to renal function. The half-life of total radioactivity is greatly lengthened in the presence of severe renal failure while the half-lives of the pharmacologically active propranolol and 4-hydroxymetabolite are slightly reduced. There is a suggestion that the absorption of propranolol is delayed in renal failure. No known pharmacological action or side effects from the other metabolic products of propranolol have been recognized. There is still too little well-documented evidence concerning the beta-blocking activity of the unidentified major metabolites of propranolol to suggest any alteration in the dosage regimen used in renal failure.

Acute Kidney Injury↗

Deceleration trauma to the heart and great vessels after road-traffic accidents.

Four young men involved in high-speed car crashes developed cardiovascular trauma. Two patients had aortic aneurysms, one rupture of the mitral valve, and one ventricular septal defect; successful surgical correction was undertaken in all. The importance of considering the possibility of cardiovascular trauma in these circumstances is emphasized, and x-ray films (repeated if necessary) should be taken even when there are no external signs of trauma.

Acceleration↗