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Biomedical subjects

G Tognoni

Publications and source records attributed to G Tognoni.

At least 271 records · Page 15Linked to original sources
PubMed1982

Quality of care of epilepsy in Italy: multi-hospital survey of diagnosis and treatment of 1104 epileptic patients.

We surveyed the treatment of 1104 patients admitted to 27 out of the 46 departments of neurology (64.5%), neurosurgery (23.0%), and child neurology (12.5%) of Lombardy, the largest Italian Region (population, 9,000,000). Our main aim was to assess the penetration of correct diagnostic and clinicopharmacological information into routine practice. A detailed analysis and discussion are given to data concerning reasons for hospital admission (therapeutic adjustment accounting for 27.3%; diagnostic ascertainment, 53.8%); characteristics of the disease, in terms of duration, clinical manifestations, and pattern of seizures; associated disorders; prevalence and criteria for the use of instrumental diagnostic procedures (EEG, brain scan, computed tomography, etc.); pattern of prescriptions of anticonvulsant drugs at admission and at discharge, with particular emphasis on specific drug choices by specialty; prevalence of single-drug therapy (41% at admission and 47.0% at discharge) versus polytherapy; degree of correspondence between recommended and observed dosage regimens (undertreatment being a more common problem than excessive dosing); and reporting of side effects. Although some of the findings of some recent studies are confirmed, this report documents the feasibility of a regular audit program of the performance of an entire health care system in the treatment of epilepsy.

Adolescent↗
PubMed1981

A multicenter study of ICU drug utilization.

As part of a view of hospital practice a sample of medical records of 15 intensive care units were analysed for the following items: reason for and origin of admission, age, sex, full pharmacological history, length of stay, clinical outcome, discharge diagnosis. Antibiotic therapy, steroid use for shock, problems of hemostasis, and cardiovascular drugs are areas where an active intervention appears to be specifically needed. Interhospital differences in diagnostic and general care criteria, documentation of inappropriate therapeutic practice, lack of reliable data registration gave occasion for an extensive discussion with clinicians leading to decisions on exclusion of drugs from hospital formularies, organization of information programs and of controlled clinical trials. The application of simple techniques of drug utilization review has proved a useful, inexpensive tool for creating favourable conditions for wide scale improvement of therapeutic practice.

Adolescent↗
PubMed1980

Pharmacokinetics of atenolol in hypertensive subjects with and without co-administration of chlorthalidone.

The pharmacokinetics of atenolol with and without the co-administration of chlorthalidone were studied in five hypertensive subjects. Concomitant administration of chlorthalidone appears to have little if any effect on the pharmacokinetics of atenolol during treatment for 7 days. The atenolol elimination half-lives were 6.7 +/- 1.1 and 6.3 +/- 0.9 h, respectively, with and without chlorthalidone. Two healthy volunteers also received a single 50 mg oral dose of chlorthalidone. Their blood profiles and pharmacokinetics were similar to those observed in hypertensive subjects, but a statistically significant difference (p < 0.01) was found between the urinary excretion half-lives of chlorthalidone. This difference may be because chronic administration of the drug caused saturation of red cell binding.

Adult↗
PubMed1978

Pharmacokinetics of furosemide in gestosis of pregnancy.

Furosemid 50 mg was administered orally and intravenously to twelve gestotic women for brief periods as a part of a randomized, multicentre clinical trial comparing the efficacy of bed rest and pharmacological treatment. The pharmacokinetic profile was investigated using a gas-liquid chromatographic technique. The plasma half-life after oral and intravenous administration was 115 +/- 37.1 and 71.8 +/- 26.3 min and plasma clearance was 153 +/- 48 and 152 +/- 23 ml/min, respectively (mean +/- SD). Comparative data from healthy pregnant women cannot be obtained for ethical reasons. The results show that gestosis has only a marginal if any effect on the kinetics of furosemide in comparison with published kinetic parameters in healthy volunteers, and patients with renal failure. The new-born babies where checked for side effects according to a protocol in use in a larger regional surveillance programme. No clinical side-effects were attributable to furosemide, but the small size of the group does not permit any definitive conclusions about this aspect.

Administration, Oral↗
PubMed1978

Kinetics and efficacy of theophylline in the treatment of apnea in the premature newborn.

Aminophylline (theophylline-ethylenediamine) was administered to 27 premature newborns to prevent apneic spells. Of the 22 patients monitored for theophylline concentration, a therapeutic blood level was reached in 19 in 1--2 days, and 3 stayed below it. "Toxic" blood levels (less than or equal to 20 microgram/ml) were reached in 3 cases, one of whom showed signs of toxicity. Theophylline treatment was not efficient in the prevention of apnea when a serious underlying disease was present. Theophylline blood half-life (mean:27.0 h) and clearance (mean 12.9 ml/h/kg) confirmed the slow elimination pattern of the drug in the premature infant.

Apnea↗
PubMed1978

Plasma concentrations of diazepam, noradiazepam and amylobarbitone after short-term treatment of anxious patients.

Twenty-four anxious inpatients were treated with diazepam, amylobarbitone and placebo, each given in flexible dosage for one week, according to a fully-balanced design. Plasma concentrations of diazepam and of its metabolite nordiazepam and of amylobarbitone were determined after two, four and seven days of treatment. Clinical and psychological assessments were made after seven days of each treatment by means of psychiatrist rating scales, patient's self-rating and a comprehensive battery of performance measures. Diazepam and nordiazepam but not amylobarbitone were accumulating over the seven days of treatment. In patients on diazepam without previous amylobarbitone, nordiazepam accumulated more rapidly than diazepam over the week so that the ratio of diazepam to nordiazepam was 2.21 after two days but only 1.14 after seven days; those with previous amylobarbitone on the other hand always had nordiazepam concentrations higher than those of the administered drug and both were accumulating equally. Diazepam and nordiazepam were still detectable in most patients two weeks after the interruption of treatment. No correlations were found between drug concentrations and clinical and psychological effects.

Adult↗
PubMed1978

Distribution of fenfluramine in normal and obese mice.

Concentrations of fenfluramine and its metabolite, norfenfluramine, were measured in blood, brain and parametrial adipose tissues 15, 30, 60 and 120 min after intraperitoneal (i.p.) administration of fenfluramine hydrochloride (10 mg/kg) to normal and gold-thioglucose obese mice. Concentrations of fenfluramine were higher in the brain of obese mice than in normal mice, while there was no difference in norfenfluramine levels in the two groups. This difference may be related to higher blood levels of fenfluramine but not of norfenfluramine in obese animals. The drug was presented in about the same concentrations in the adipose tissue of the two groups. These results may explain previous findings that fenfluramine was more effective as an anorectic agent in obese than in lean mice.

Adipose Tissue↗
PubMed1977

Human pharmacokinetics and bioavailability of temazepam administered in soft gelatin capsules.

Plasma levels of temazepam were determined in healthy subjects after single oral administration of soft and hard gelatin capsules, and after 7 consecutive night-time doses in soft capsules. Absorption from soft gelatin capsules was significantly faster and produced earlier and higher peak plasma levels. The two pharmaceutical forms did not show any significant difference in relative availability. The apparent half-life of temazepam after night-time administration was significantly shorter than after morning administration, but no change in half-life was observed between the first and seventh night-time doses.

Adult↗
PubMed1977

Plasma levels of di-no-propylacetate and clonazepam in epileptic patients.

Plasma levels of DPA and CNP and associated antiepileptic drugs were measured in groups of respectively 106 and 30 epileptic patients aged from 3 to 49 years. A poor correlation between daily oral dose and plasma levels of both drug was observed when the whole group of patients was considered. A better correlation was seen in a group of adult patients who received DPA and PB. Children below 10 years of age disposed both drugs faster than adults and the difference was significant (p less than 0.01) in groups receiving PB as associated drug. Patients medicated with PB and DPA or CNP showed lower plasma levels of both drugs; on the other hand DPA appeared to cause a decrease of PB clearance which was more marked in children. The clinical significance of the fluctuations of daily plasma levels of both drugs are discussed in relationship to the schedule of administration and plasma sampling. Observations on the therapeutic ranges and adverse effect of the drugs are reported.

Adolescent↗
PubMed1977

Bioavailability and platelet aggregation inhibitory activity of solufenum. A comparison with ibuprofen.

Bioavailability and platelet aggregation inhibitory activity of the lysine salt of ibuprofen (solufenum) were compared with those of the parent molecule in 5 healthy male volunteers. The study had a randomized, cross-over design. The average peak plasma level and the area under the curve were higher when solufenum was administered orally as compared to the same preparation given i.m. or as compared to oral ibuprofen. However, the bioavailability of the 3 preparations studied was not significantly different. In contrast, the inhibitory effect on adrenaline-induced platelet aggregation appeared significantly different. In contrast, the inhibitory effect on adrenaline-induced platelet aggregation appeared significantly earlier after the administration of both solufenum than after ibuprofen. The clinical relevance of these findings is discussed.

Adult↗