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Biomedical subjects

J G Kelly

Publications and source records attributed to J G Kelly.

At least 91 records · Page 5Linked to original sources
PubMed1978

The clinical pharmacology of mexiletine.

1. Mexiletine was given to 156 patients by intravenous or oral routes of administration. 2. There was great interpatient variation in kinetics and plasma concentrations with both routes of administration. 3. The mean volume of distribution was 6.63 l/kg. The mean plasma elimination haf-life after chronic oral therapy was 11.31 h. 4. Plasma concentrations between 0.75 and 2.00 microgram/ml were usually effective. Within this therapeutic range severe side effects were uncommon. 5. Plasma concentrations within this range were achieved in 72% of patients when doses of 10--14 mg-1 kg-1 day were given orally.

Administration, Oral↗
PubMed1978

Plasma protein binding of propranolol and isoprenaline in hyperthyroidism and hypothyroidism.

1. The possibility that thyroid disease might result in alterations in the plasma proteins binding of drugs has been investigated by studying the binding of propranolol and isoprenaline in patients with hyperthyroidism and hypothyroidism. 2. Plasma protein binding of propranolol and isoprenaline has been measured in seven hyperthyroid patients and ten hypothyroid patients. Plasma binding was estimated by equilibrium dialysis at 37 degree C using triatiated propranolol and isoprenaline, both when the patients had thyroid dysfunction and again when they were euthyroid. 3. In the hyperthyroid group, mean propranolol binding varied from 86 +/- 1.7% when hyperthyroid to 88.4 +/- 0.8% when euthyroid. The comparable isoprenaline figures were 65.1 +/- 3.2% and 68.1 +/- 1.4% respectively. Neither difference was significant. 4. Isoprenaline binding was significantly lower (64.3 +/- 1.6%) when patients were hypothyroid than when they became euthyroid (68.8 +/- 1.2%). Propranolol binding was not altered by hypothyroidism. 5. It is concluded that clinically important alterations in free drug concentrations of propranolol or isoprenaline do not occur in hyperthyroidism or hypothyroidism.

Adult↗
PubMed1978

Role of neural influences in the release of gastrin, glucagon, and secretin during hypoglycaemia in man.

Both vagal and sympathetic innervation been have described as influencing hormone release from the gastrointestinal tract and pancreas. The role of neural influences on the release of gastrin, glucagon, and secretin has been studied using the potent autonomic nerve stimulus of hypoglycaemia. Healthy subjects were each rendered hypoglycaemic by insulin 0.2 units/kg on three occasions: after atropine 20 microgram/kg: after propranolol 160 mg orally, and without prior drug administration. Adequate beta-blockade was confirmed by observation of the pusle rate response to a standard exercise at the end of the experiment, and by measurements of plasma propranolol levels. Hypoglycaemia failed to produce a rise in plasma gastrin under either propranolol or control conditions but a significant rise was noted with prior atropinisation. The glucagon response to hypoglycaemia, when measured with either the C- or N-terminal reactive antibodies, was found not to be influenced to any significant extent by either beta-blockade or atropinisation. No alteration in plasma secretin levels was noted during hypoglycaemia. It therefore appears that neural influences are relatively unimportant in the release of gastrin, glucagon, and secretin in man.

Adult↗
PubMed1978

Do patients take digoxin?

Plasma digoxin concentrations on admission to hospital have been compared with levels on day 8 in a group of 50 patients who were maintained on their preadmission digoxin doses for 7 days. In the absence of a change in renal function, 18 patients (36%) had higher levels on day 8 and were considered to be non-compliant: a further 7 patients (14%) had lower levels on day 8 suggesting that before admission they had been taking more than their prescribed digoxin dose. Fifty per cent were, therefore, taking their digoxin improperly. In addition, an incorrect dose of digoxin may have been prescribed in 14 patients (28%) with plasma digoxin concentrations either below 0.8 ng/ml (1.02nmol/l) or above 2.0 ng/ml (2.56 nmol/l) on day 8. Long-term compliance was assessed by comparing day 8 'steady state' digoxin levels with those obtained at outpatient follow-up. Thirty of the original group were studied at 4 weeks when 27 per cent were considered non-compliant, and 20 at 3 months when 30 per cent were non-compliant. These results have serious implications both for drug prescribing and for the treatment of disease, and suggest that a problem of communication exists between doctors and their patients.

Aged↗
PubMed1978

Observations on intravenous administration of lignocaine in patients with myocardial infarction.

Lignocaine was administered intravenously to 36 patients with acute myocardial infarction. A bolus of 100 mg followed by an infusion of 2 mg/minute failed to maintain plasma levels above 2 microgram/ml. A bolus of 100 mg followed by 4 mg/minute also failed to maintain satisfactory plasma concentrations during the first hour of therapy. A bolus of 75 mg was combined with an infusion of 10 mg/minute for 20 minutes followed by 1.5 mg/minute. Satisfactory plasma concentrations during the first hour were observed in 94 per cent of the estimations. No important adverse side effects occurred during the infusion of 10 mg/minute.

Arrhythmias, Cardiac↗