Search PubMed⌕ Search

Biomedical subjects

H F Morrelli

Publications and source records attributed to H F Morrelli.

16 recordsLinked to original sources
PubMed1981

Systemic alkalosis and digitalis related arrhythmias.

Reviews of large series of patients with digitalis-induced arrhythmias create a seeming paradox: Hypokalemia is infrequently associated with digitalis-induced arrhythmias but the clinical benefit of supplementation of potassium for most digitalis-induced arrhythmias is obvious. Examination of the electrophysiologic abnormalities induced by digitalis coupled with the electrophysiologic effects dependent on the ratio of intracellular to extracellular concentrations of potassium clarifies the issue. We present evidence that supports additive effects of the toxicity of digitalis and abnormal ratios of concentrations of potassium inside and outside the cardiac cell using metabolic alkalosis as a marker of intracellular potassium depletion. Patients with metabolic alkalosis and normokalemia with "therapeutic" concentrations of digoxin had significantly greater prevalence of arrhythmias than did patients without alkalosis. We presume this effect of alkalosis to be mediated by effects on extra- to intracellular ratios of potassium.

Adult↗
PubMed1977

Digoxin toxicity in patients with normokalemic potassium depletion.

Reviews of large series of patients with digitalis-induced arrhythmias create a seeming paradox: Hypokalemia is infrequently associated with digitalis-induced arrhythmias but the clinical benefit of supplementation of potassium for most digitalis-induced arrhythmias is obvious. Examination of the electrophysiologic abnormalities induced by digitalis coupled with the electrophysiologic effects dependent on the ratio intracellular to extracellular concentrations of potassium clarifies the issue. We present evidence that supports additive effects of the toxicity of digitalis and abnormal ratios of concentrations of potassium inside and outside the cardiac cell. We provide guidelines for assessing this crucial ratio of intracellular to extracellular concentrations of potassium to aid the clinician in the diagnosis and effective treatment of digitalis-induced arrhythmias.

Adult↗
PubMed1975

Chelation therapy.

This statement was prepared in response to a request made to the Clinical Pharmacology Service at the University of California, San Francisco to evaluate the potential therapeutic uses and the possible toxicities of chelation therapy. The question arose in regard to the use of ethylene tetraacetic acid (EDTA) in the treatment of atherosclerotic cardiovascular disease.

Calcinosis↗
PubMed1973

Propranolol.

Explore the source record for details and available documents.

Administration, Oral↗
PubMed1973

Letter: Propranolol.

Explore the source record for details and available documents.

Arrhythmias, Cardiac↗
PubMed1972

Drug interactions.

Explore the source record for details and available documents.

Drug Interactions↗
PubMed1969

Drug interactions.

Explore the source record for details and available documents.

Acid-Base Equilibrium↗
PubMed1968

The clinician's approach to drug interactions.

Drug interactions are important causes of both unexpected toxic and therapeutic effects. Adverse reactions due to drug interaction are proportional to the number of drugs given and the duration of administration. Although drug interactions may be beneficial, they are most often recognized when they increase mortality or morbidity. The frequency of adverse drug interactions in clinical practice makes it mandatory for physicians to know the drugs and mechanisms involved.A drug may potentiate or antagonize the effects of another drug by direct chemical or physical combination, by altering gastrointestinal absorption, by influencing metabolism, transport, or renal clearance, by changing the activity of a drug at its receptor site, or by modifying the patient's response to the drug by a variety of means. This article stresses the importance of avoiding multible drug therapy. When such treatment is unavoidable, patients must be carefully observed for evidence of intensified or diminished drug effect. Only this permits the detection and prevention of untoward drug interactions.

Acid-Base Equilibrium↗