Cimetidine and active duodenal and prepyloric ulcers.
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Clinical Trials as Topic↗
Biomedical subjects
G Bodemar
Publications and source records attributed to G Bodemar.
Pharmacokinetics of cimetidine after single doses and during continuous treatment.
The plasma concentration-time curve and urinary excretion of cimetidine were followed in 10 patients after single 200mg doses given intravenously, in 9 patients after 400 and 800mg single oral doses, and in 10 patients over a 24-hour period during continuous oral treatment with 1000mg daily. The bioavailability of cimetidine measured as the ratio between the areas under the plasma concentration-time curves (AUC) after oral and intravenous administration was 76%. The mean excretion of cimetidine in the urine as unchanged drug, expressed as a percentage of administered dose, was 58% after 200mg intravenously and between 37 and 41% after single oral doses of 200, 400 and 800mg and during continuous treatment with 1.0g/day. Since there were no significant differences between the oral doses, the relative bioavailability of cimetidine does not appear to be dose-dependent. The AUC after the 800mg dose was 2.1 times that of the 400mg dose. No dose-dependent kinetics were observed. There were also no significant differences in the AUCs after 200 and 400mg doses during continuous treatment compared with the AUCs after the same single doses. Thus, cimetidine does not appear to induce or inhibit its own metabolism during treatment. Following intravenous administration, the mean volume of distribution was 1.39L/kg and the mean total body clearance and the mean plasma renal clearance of cimetidine were 655 and 375ml/min, respectively. A renal clearance of cimetidine more than 3 times higher than the creatinine clearance demonstrates that the renal excretion of cimetidine is mainly by tubular secretion. Plasma concentrations of cimetidine during continuous treatment with 1.0g/day were above 1.0 microgram/ml-the plasma concentration associated with 50% inhibition of stimulated acid secretion in peptic ulcer patients-for 9 out of the 24 hours. A morning plasma concentration above 0.6 microgram/ml before the next morning dose has been taken during treatment with cimetidine 1.0g/day is only seen in patients with some degree of renal failure. Measurement of plasma half-life during continuous treatment shows that the plasma half-life is longer than the mean 1.79 hours estimated after intravenous administration of a single dose.
Adult↗
Steady-state kinetics and dosage requirements of cimetidine in renal failure.
25 patients with different degrees of chronic stable renal failure received oral treatment with cimetidine over 6 days and a final dose in the morning of day 7. The doses of cimetidine were reduced according to the degree of renal failure. Plasma concentrations of cimetidine were determined before the morning dose on days 2,3,6 and before the final morning dose and during the day on day 7. 24-hour excretions of cimetidine were measured during the study and on day 7, 6 to 9 hours after the final morning dose. There were significant linear relationships between the values of creatinine clearance and plasma elimination rate constant of cimetidine (p less than 0.0025) and between the values of creatinine clearance and renal clearance of cimetidine (p less than 0.05). On the basis of the morning plasma concentrations before and the plasma concentration curve after the final morning dose on day 7 the following dose recommendations according to pretrial values of creatinine clearance are recommended for cimetidine treatment in renal failure: 5 to 15ml/min 200mg 2 or 3 times daily, 15 to 30ml/min 200mg 3 times daily and 30 to 75ml/min 200mg 4 times daily.
Adult↗
A statistically rule-based decision support system for the management of patients with suspected liver disease.
The paper describes how a decision support system in liver diseases, mostly oriented to prediction of the necessity for liver biopsy, has been developed. The system designed is a hybrid one and consists of two parts: logical and statistical. The logical part contains rules, formulated on the basis of current medical knowledge, which enables recognition of clear cases; diseased or non-diseased. The unclear cases are classified on the basis of rules statistically extracted from databases. These rules have been reached after a comprehensive exploratory analysis of the sample of 165 patients with slightly to moderately raised levels of routine liver tests but without signs or symptoms of liver diseases. The extracted decision diagrams which simulate traditional medical diagnosis conduct have been found to be superior to discriminant analysis and probabilistic inductive learning. They use only a limited number of laboratory tests to detect the necessity for biopsy.
Algorithms↗
Pancreatic ductal morphology and exocrine function in primary sclerosing cholangitis.
The possible association of pancreatitis with primary sclerosing cholangitis was studied in 17 patients. At endoscopic retrograde cholangiopancreatography (ERCP) four patients (24%) were found to have pancreatic changes in addition. The secretin test was abnormal in one patient, who also had morphological signs of pancreatitis at ERCP. One patient had raised basal serum concentrations of amylase and lipase, and another had decreased pancreatic amylase; these two patients had normal findings on ERCP and normal secretin tests. The findings suggest that pancreatic changes are present in a proportion of patients with primary sclerosing cholangitis despite the lack of clinical suspicion of pancreatitis. The pancreatic damage, however, seems to be confined to alterations in ductal morphology rather than including functional impairment.
Adult↗