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Biomedical subjects

H Walther

Publications and source records attributed to H Walther.

At least 181 records · Page 10Linked to original sources
PubMed1980

[Serum anticonvulsant levels in therapy-resistant epileptics].

The continuous occurrence of particularly severe epileptic attacks represent a great stress for the patients. For this reason, we have conducted anticonvulsant blood-level studies particularly in these patients, this paper being based on 146 first determinations. Among the patients, most of whom are adults and are treated with combinations of drugs, only 24 per cent reached the assumed normal phenytoin range while 69 per cent remained below it. With the administration of phenobarbital, however, 50 per cent reached the therapeutic range and only 14 per cent reached the lower limiting value. It is only i the last-mentioned group that we assumed primarily an insufficient intake of the drugs while with DPH the problems of the determination of the plasma water range had to be discussed. In practice, blood level determinations have their special value for the detection of the intake of a wrong dosage of the drugs as well as bland anticonvulsant intoxications.

Adult↗
PubMed1980

[Effect of phenobarbital on self-ratings of healthy subjects in comparison to the objective impairment of their performance].

The influence of phenobarbital (1.0, 3.0, 4.0, 6.0 and 8.0 mg/kg) on cognitive, psychomotor and reaction performance as well as the subjective self-assessment was studied in healthy volunteers. Threshold doses were determined, at which initiating impairment of the performance was evident, the self-ratings being the most sensitive indicator. Ranking next in terms of sensitivity were cognitive and other performance tests. In connection with the present results the term "hypnotic dose" is critically evaluated. Whether or not a dose produces a hypnotic effect is believed to be primarily governed by the activation level of volunteers of patients. Moreover, the results presented emphasize that a valid assessment of the drug influence on performance is possible only by objective tests and subjective self-ratings to be accomplished simultaneously.

Adult↗
PubMed1979

[Serum level determination in patients with acute myocardial infarction under diphenylhydantoin therapy].

For the therapy of disturbances of the cardiac rhythm with phenytoin 3 different dosage regimes are examined, in which cases an oral application of phenytoin proves as not suitable. Only by a stepped infusion with following oral treatment a rapid saturation and therapeutically effective serum levels are achieved which are decisive for the effectiveness of the therapeutic measures.

Administration, Oral↗
PubMed1979

Interindividual differences of protein binding in man.

Using equilibrium dialysis protein unbound fractions of phenytoin (390 patients) and phenobarbital (220 patients) revealed serum protein bindings of 8 to 40 per cent and 25 to 80 per cent, respectively. For the purpose of therapy service, this pronounced interindividual variability required in the case of a great number of patients the determination of the extent of protein binding so as to exactly evaluate therapeutical failures or occurrence of undesirable effects.

Blood Proteins↗
PubMed1979

[Studies on the separation and photometric determination of antiepileptics (author's transl)].

Well-known methods for the photometric determination of antiepileptics in body fluids were tested from the aspect of their utilization in a pharmacokinetic therapy service of clinical pharmacology. In the framework of a comparative synopsis of methods, specifications are given for the determination of phenytoin, phenobarbital, methylphenobarbital, and carbamazepine.

Anticonvulsants↗
PubMed1978

Effectiveness of analgesics evaluated with the tourniquet technique.

The analgesic effectiveness of acetylsalicyclic acid, noramidopyrinium methane sulfonate sodium, pentazocin and codeine phosphate was studied in 19 healthy male and female subjects between 25 and 65 years of age by means of two variants of the tourniquet technique. Compared with placebo, no differences in effectiveness were found using a double-blind approach; primarily because of the low reliability of the method.

Adolescent↗
PubMed1978

[Optimizing the therapeutic process in long-term antiepileptic therapy through the determination of drug levels in patients].

Serum levels of phenytoin, phenobarbital, carbamazepine, and ethosuximide were determined in about 2,000 subjects treated on an outpatient and inpatient basis, respectively. Therapeutical serum level ranges were obtained in about 50 percent of the patients. In the other patients, the values determined were either too low or too high. These studies, in addition to enabling the drug-taking behavior of patients to be objectified, made possible "blood-level-oriented dosage" and allowed differential approaches to be adopted in the control of undesirable effects. Blood level determinations permit the therapeutical procedure to be improved and made more reliable especially in "problem cases". A pharmacokinetic therapy service has proved useful for long-time antiepileptic therapy.

Anticonvulsants↗
PubMed1978

Dosage monitoring through measurement of serum level--a task of clinical pharmacology.

Dosage monitoring or "pharmacokinetic therapy service", respectively, covers blood level governed therapy schedule or blood level controlled dosage for certain types of therapy. It is also advantageous in applying drugs of a small therapeutic range or in "risk" patients such as children, old men and patients suffering from elimination disturbances. With the blood level data known, physicians can follow an optimum therapy schedule. The principle of this service is detailed using therapy with antiepileptics as an example. Through substantiation is given.

Adult↗
PubMed1977

[Functional assessment of coronary-artery stenosis (author's transl)].

Left-ventricular angiography was performed in 28 patients after measuring ascending aortic and left ventricular pressures and during isometric exercise (hand grip, 0.3-0.4 kg/cm2 for 3 min). In 13 patients coronary blood flow was measured at rest and during hand-grip exercise by means of the argon method. Eight patients without heart disease served as controls. In 14 patients with coronary heart disease abnormal left-ventricular kinetics, demonstrated already at rest, got worse during hand-grip exercise. In five patients with normal left-ventricular angiograms at rest hypokinesia and dyskinesia occurred during isometric exercise. The coronary artery supplying the abnormal ventricular wall had a 50-75% decrease in diameter. One patients with isolated 25% stenosis had normal left-ventricular kinetics both at rest and on hand-grip exercise. In all patients coronary blood flow rose by 60-90% during isometric exercise. It iducing a significant rise in myocardial oxygen demand and increased coronary blood flow.

Angiography↗