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Biomedical subjects

J E Murphy

Publications and source records attributed to J E Murphy.

At least 109 records · Page 6Linked to original sources
PubMed1980

Carbamazepine-induced leukocytosis.

An apparent case of carbamazepine-induced leukocytosis in a 26-year-old woman is presented. When admitted for psychiatric evaluation, the patient had been receiving carbamazepine for seizures for some time. A hemogram revealed a white blood cell (WBC) count of 21.2 x 10(3)/cu mm. Five days after the patient's medication was changed from carbamazepine (600 mg/day) to phenytoin (400 mg/day) and phenobarbital (120 mg/day), her WBC count was within normal range. When she experienced dizziness and ataxia, the phenytoin and phenobarbital were replaced with carbamazepine (600 mg/day). WBC counts performed 11 and 13 days after resumption of carbamazepine therapy again were significantly elevated. Other drugs administered during hospitalization included chlorpromazine, acetaminophen, and codeine. The possible causes of and pathophysiology of leukocytosis are reviewed. The changes in WBC that occurred with the rechallenge of carbamazepine indicate that the drug was the probable cause of the leukocytosis.

Adult↗
PubMed1979

Piroxicam in the treatment of acute gout: a multicentre open study in general practice.

Twenty-nine patients with acute gout were treated with piroxicam (40 mg daily for 5 days) in a multicentre general practitioner study. Pain relief was noticeable within 4 hours of the first dose and thereafter proceeded steadily, together with the early relief of other symptoms associated with acute gout. The prompt relief of symptoms was accompanied by a fall in serum uric acid. Piroxicam was well tolerated, eight experiencing side-effects that were mainly mild and gastro-intestinal in nature. The drug seems to be highly effective and safe in the treatment of acute gout.

Acute Disease↗
PubMed1979

Efficacy of antiparkinson agents in preventing antipsychotic-induced extrapyramidal symptoms.

The types of extrapyramidal syndrome (EPS) reactions produced by antipsychotic agents and the prophylactic use of antiparkinson agents in preventing EPS are reviewed. EPS are classified as akathisias, dystonias, parkinson-like symptoms and tardive dyskinesia, and have a varied incidence reported to range from 10.6 to 100%. Incidence may vary with age, gender, drug and dosage. The prophylactic use of antiparkinson agents to prevent EPS is controversial. Many psychiatrists believe the effect of EPS on patients is more harmful than the side effects of anticholinergics, whereas others believe that because of side effects, increased cost, greater risk to tardive dyskinesia and improper use, the use of antiparkinson agents cannot be justified. Most studies of prophylactic use of antiparkinson agents have lacked adequate control groups, adequate blinding procedures for investigators rating EPS, uniform definitions of EPS, random sampling and careful reporting of group characteristics such as dosage and drugs received. There is a lack of definitive studies of the value of antiparkinson agents in preventing the occurrence of EPS in patients receiving antipsychotics. A large, multicenter study should be undertaken to resolve the issue.

Antiparkinson Agents↗
PubMed1978

A comparative clinical trial of mianserin (Norval) and amitriptyline in the treatment of depression in general practice.

A double-blind controlled comparative trial of mianserin (Norval) and amitriptyline was conducted in general practice. Fifty-one patients were treated with amitriptyline and fifty-five with mianserin. The dosage for the first week was 25 mg t.d.s. for amitriptyline and 10 mg t.d.s. for mianserin, increasing to 50 mg t.d.s. and 20 mg t.d.s. respectively for the subsequent three weeks. Both drugs proved equally effective in relieving the symptoms of primary depression but mianserin showed a reduced incidence of side-effects which was statistically significant.

Adolescent↗
PubMed1978

Analgesic efficacy and acceptability of fenoprofen combined with paracetamol and compared with dihydrocodeine tartrate in general practice.

A single-blind between-patient study in general practice was made to examine the acceptability and analgesic efficacy of a combination of fenoprofen (200 mg) and paracetamol (500 mg) given 3 to 4 times daily for a period of 4 to 14 days in the treatment of acute and chronic pain. The combination was compared with dihydrocodeine tartrate (30 mg) in two groups of 75 patients suffering from a wide variety of presenting conditions, including osteo-arthritis, spondylitis, lumbago, sciatica, non-articular rheumatism and trauma. Clinical and patient assessment indicated that the combination was an effective analgesic combination, significantly better in success rate than dihydrocodeine tartrate and with a much lower incidence of side-effects (13% of patients receiving fenoprofen and paracetamol reported side-effects compared to 37% for the dihydrocodeine group). The combination demonstrated particular success in the treatment of non-articular rheumatism.

Acetaminophen↗
PubMed1978

Mianserin in the treatment of depressive illness and anxiety states in general practice.

1. In an initial study in general practice, mianserin was shown to be of similar antidepressant efficacy to imipramine. 2. A subsequent placebo-controlled study confirmed that mianserin is an effective as imipramine, and also demonstrated that both mianserin and imipramine are superior to placebo in the treatment of depression in general practice. 3. In a third trial, mianserin was found to be as effective as diazepam in the treatment of anxiety states in general practice. 4. The overall incidence of side-effects in this series of studies, either with mianserin or with the comparison drugs, was very low.

Adolescent↗
PubMed1977

A comparative trial of Anafranil, Pertofran and an Anafranil/Pertofran combination.

On the grounds of different pharmacological properties and possibly different clinical effects, two antidepressants, Anafranil (clomipramine) and Pertofran (desipramine) were compared in the management of depression in general practice. A further comparison was made to ascertain whether a combination of the two antidepressants was more effective than the drugs given alone. One hundred and seventy-three patients were admitted to a double-blind clinical trial, conducted on a multicentre basis in general practice, in which a double-dummy technique was employed. One hundred and forty-one patients completed the study. Of these, 49 received Anafranil, 49 received Pertofran and 43 the combination. Although there were no statistically significant differences between the three treatment regimes, there was a consistent trend in favour of the combination regime. Ninety-one per cent of the patients who completed treatment on the combination showed satisfactory improvement compared with 81% on the Anafranil regime and 78% on Pertofran. An attempt was made to identify three symptom clusters--anxiety, 'anergia' and biological depression. There was no significant difference in the response of these three clusters to the three treatment regimes, nor was there any difference in the incidence and severity of side-effects.

Adolescent↗
PubMed1977

A comparison of Ludiomil, Tryptizol and Lentizol.

One hundred and seventy-six patients were admitted to an open, multicentre, comparative trial of Ludiomil, Tryptizol SR and Lentizol, each administered in a dose of 75 mg at night. Fifty-seven patients received Tryptizol SR, 60 received Lentizol and 59 received Ludiomil. Nine patients on Tryptizol SR, 10 patients on Lentizol and 6 patients on Ludiomil dropped out for a variety of reasons. A seventeen-symptom rating scale was used and the symptoms analyzed individually. A greater response in the severity and number of symptoms was seen in the first week of treatment on Ludiomil though the differences rarely reached the acceptable level of statistical significance. Global assessments did not reveal any differences between the groups. Side-effects were also similar. Only dry mouth and drowsiness were persistent problems.

Adult↗
PubMed1976

A single-blind comparative clinical trial of lymecycline and amoxycillin in the treatment of acute bronchitis in general practice.

A single-blind comparison of lymecycline and amoxycillin was performed by three general practitioners in the treatment of acute bronchitis. A total of 132 patients were treated for seven days with lymecycline (204 mg) two capsules twice daily or amoxycillin 250 mg three times daily. Symptoms and signs assessed were cough, dyspnoea, sputum volume, purulence of sputum and temperature. Both drugs brought about a statistically significant improvement. For all parameters the improvements seen with lymecycline were superior to those seen with amoxycillin although in no case did any of these reach statistical significance. However, in the case of purulent sputum those patients receiving lymecycline showed improvement which reached borderline significance (0-05 less than p less than 0-1) as compared with amoxycillin. Side-effects in the case of both drugs were negligible.

Acute Disease↗
PubMed1976

The addition of Visken to methyldopa therapy in hypertension: a multicentre study.

Forty-one patients completed the study where Visken was added to the treatment regimen of patients whose blood pressures were poorly controlled on methyldopa or who were experiencing side-effects with methyldopa. Supine blood pressure was reduced from 177/108 mm Hg before Visken therapy to 159/96 mm Hg after twelve weeks of taking Visken. The dose of methyldopa was reduced from a mean 921 mg at the start to 445 mg at the end. Fourteen patients were able to stop methyldopa therapy. The number of side-effects reported was reduced as the study continued and fifteen patients commented that they felt better on Visken. Nine patients did not complete the trial, three of these because of side-effects, viz insomnia, lethargy and sleep disturbances.

Blood Pressure↗
PubMed1976

A comparative study of talampicillin and ampicillin in general practice.

Talampicillin hydrochloride, the phthalidyl ester of ampicillin, when given in a dosage containing the equivalent of 125 mg of ampicillin four times daily for six days to general practice patients, has proved to be as effective, both clinically and bacteriologically, as 250 mg of ampicillin given four times daily for six days. Although the over-all incidence of side-effects was similar with both preparations, diarrhoea was significantly reduced in talampicillin-treated patients. Possible reasons for this are discussed. Talampicillin therefore offers certain advantages over ampicillin in producing effectiveness equivalent to that of ampicillin at a lower dosage level with a reduced incidence of diarrhoea.

Adolescent↗
PubMed1976

Mianserin in the treatment of depression in general practice.

In a double-blind study in general practice, both mianserin ('Bolvidon') in an average dose of 40 mg a day, and imipramine, in an average dose of 100 mg a day, were found to be significantly more effective than placebo after two to three weeks' treatment. No significant differences in antidepressant effect could be demonstrated between mianserin and imipramine. There was no significant difference in side-effects between the three treatments.

Adolescent↗