Search PubMed⌕ Search

Biomedical subjects

J P Kampmann

Publications and source records attributed to J P Kampmann.

At least 19 recordsLinked to original sources
PubMed2000

Pharmacokinetic studies of neuromuscular blocking agents: good clinical research practice (GCRP).

In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines for good clinical research practice (GCRP) in pharmacokinetic studies of neuromuscular blocking agents is presented. Guidelines include: design of the study; relevant patient groups to investigate; test drug administration, sampling and analysis; pharmacokinetic analysis; pharmacokinetic/pharmacodynamic modeling; population pharmacokinetics; statistics; and presentation of pharmacokinetic data. The guidelines are intended to aid those working in this research area; it is hoped that they will assist researchers, editors of scientific papers, and pharmaceutical companies in improving the quality of pharmacokinetic studies.

Body Temperature↗
PubMed2000

Bioavailability and pharmacokinetics of isradipine after oral and intravenous administration: half-life shorter than expected?

Isradipine is a calcium channel-blocking agent of the dihydropyridine type, used in the treatment of hypertension. A terminal half-life of 8-9 hr has been reported, in several pharmacokinetic studies after oral administration of isradipine. In a yet unpublished study a much shorter half-life was observed, and the present trial was therefore conducted in order to estimate the half-life after intravenous administration of isradipine. The bioavailability was estimated as well. In a randomised cross-over design ten healthy young volunteers were given either isradipine orally or an intravenous infusion. The two study periods were separated by at least 3 days. Blood samples for measurement of isradipine concentration were collected for 10-12 hr after administration and half-life and bioavailability were estimated. Mean terminal half-life after intravenous administration was calculated to be 2.8 hr, and the bioavailability to be 0.28. None of the 10 subjects suffered from side effects. In the present intravenous study the half-life of isradipine seems to be of much shorter than demonstrated in previous oral studies.

Administration, Oral↗
PubMed1999

Steroid reversibility test followed by inhaled budesonide or placebo in outpatients with stable chronic obstructive pulmonary disease. The Danish Society of Respiratory Medicine.

The aim of this study was evaluate the predictive value of a 2 week course of prednisolone on the effect of 6 months treatment with inhaled budesonide in patients with stable chronic obstructive pulmonary disease (COPD). Forty patients with stable COPD entered the study, and received prednisolone (37.5 mg o.d.) for 2 weeks. They were subsequently divided into steroid-irreversible and steroid-irreversible, using 15% of baseline as a dividing point. In each group patients were randomized to receive budesonide 400 micrograms b.i.d. or placebo for 6 months. During treatment with prednisolone, three patients dropped out because of side effects. Of the remaining 37, only two patients (5%) were reversible with prednisolone forced expiratory volume in 1s [(FEV1) > 15% of baseline], and among the steroid-irreversible, 26 patients were evaluated after 6 months treatment with either placebo or budesonide. No significant differences in spirometry values, symptoms, or number of exacerbations were found between these two groups. Reversibility with prednisolone is rarely seen in COPD. In outpatients with stable COPD and no signs of asthma or atopy, 2 weeks treatment with prednisolone seems to be of no value in choosing subsequent long-term therapy.

Adolescent↗
PubMed1998

[Discrepancies between medical records and dispensing records in two large hospital departments in Copenhagen].

This study was performed to investigate the possible differences between prescribed medicine, as entered in the hospital record, and the medicine dispensed to the patients according to the nurse's dispensing records (NDR's) in two clinical departments at a Copenhagen University Hospital. Discrepancies were defined as either dosage differences or drugs only present in one file, and were divided into major and minor discrepancies, according to clinical significance. In the first department, discrepancies were found in 61.4% of the records, and major discrepancies were found in 35.1%. In the second department, discrepancies were found in 70.5% of the cases, and major discrepancies in 42.5%. No correlation was found between the number of drugs per patient and the number of discrepancies. A significant difference exists between what is prescribed, and what is dispensed. This can have clinical as well as legal consequences.

Denmark↗
PubMed1997

Dose-finding study of oral metopimazine.

A few studies indicate a dose-response effect of the antiemetic metopimazine. The aim of this study was therefore to investigate the tolerability of increasing doses of metopimazine given orally every 4 h for eleven doses. The dose levels 20 mg, 30 mg, 40 mg, 50 mg and 60 mg were studied in 36 patients completing 46 cycles of chemotherapy. Serum concentrations of metopimazine and the acid metabolite AMPZ were measured by HPLC in 13 patients (15 cycles). The dose-limiting toxicity was moderate to severe dizziness caused by orthostatic hypotension as seen in 0, 0, 17%, 42% and 50% of patients at the respective dose levels. Other side effects were few and mild, and only a single possible extrapyramidal adverse event was observed in a patient at the 60-mg dose. High serum concentrations were not predictive for toxicity, as found on comparison of patients with and without symptoms, but in individual patients symptoms were seen at the time of Cmax. We found that metopimazine was safe with a dosage of 30 mg x 6. This dose is four times higher than that previously recommended for antiemetic use.

Administration, Oral↗
PubMed1997

Smoking related to 24-h ambulatory blood pressure and heart rate: a study in 352 normotensive Danish subjects.

This study shows the association between smoking and both office and ambulatory blood pressure. By means of stratification, a uniform number of subjects of both sexes and spanning 6 decades (aged 20 to 79 years) were recruited randomly from the local community register. A total of 352 subjects participated, including 161 smokers. Smokers (both sexes and all age groups summed), as compared with nonsmokers had statistically significant lower office blood pressure as follows (mean systolic +/- SED/mean diastolic +/- SED): (systolic and diastolic, -6.8 +/- 2.1/-3.9 +/- 1.3); day ambulatory blood pressure (diastolic, /-2.8 +/- 1.0); and night ambulatory blood pressure (systolic and diastolic, -4.2 +/- 1.8/-3.9 +/- 1.1). The intraperson variability of the day ambulatory blood pressure (as measured every 15 min) was identical for the smokers and the nonsmokers. Smokers were found to have a diminished "white coat" effect; this diminished white coat effect has not previously been described. The major white coat effect was seen in the older nonsmokers, whereas the diminished white coat effect was most pronounced in the older male smokers and in the younger female smokers. Smokers seem to have a diminished white coat effect, as well as a lower ambulatory blood pressure throughout the day (diastolic) and at night (systolic and diastolic). The similar intraperson variability found in the smokers' and nonsmokers' blood pressure further speaks for a consistently lower blood pressure in smokers as compared with nonsmokers.

Adult↗
PubMed1996

[Round-the-clock blood pressure measurements in 352 persons--a reference material].

The aim of this study was to establish reference values for 24-hour ambulatory blood pressure in a Danish population stratified for gender and age in the decades from 20 to 79 years of age. A sample of 352 persons, 179 men and 173 women randomly selected from the local community register, age 20-79 years underwent 24-h ambulatory blood pressure monitoring. For men age < 50 daytime ambulatory blood pressure (median) was 125/79 mmHg and night time was 106/65 mmHg, for women the respective pressures were 113/77 mmHg and 97/64 mmHg. For men age > or = 50 daytime ambulatory blood pressure was 133/83 mmHg and night time was 124/86 mmHg, for women the respective pressures were 122/83 mmHg and 105/65 mmHg. Presently, we can only relate cardiovascular risk to clinic blood pressure. Therefore we have calculated corresponding ambulatory blood pressure values to WHO's upper limit 160/90 mmHg for normal blood pressure in the clinic and found 154/87 mmHg for daytime and 134/74 mmHg at night. For a clinic pressure of 95 mmHg the corresponding daytime value was 91 mmHg, for 100 mmHg it was 95 mmHg.

Adult↗
PubMed1995

Aminoglycosides: single or multiple daily dosing? A meta-analysis on efficacy and safety.

A number of randomised studies indicate that a single high dose of aminoglycoside every 24 h may be more efficient and less toxic than the same dose divided into multiple daily doses. In the meta-analysis of 16 studies described here, which included more than 1200 patients, the relative chance (i.e. the relative risk, RR) of cure of the single-dose regime compared with the multiple-dose regime was 1.027, indicating that the single daily dose regime had a 2.7% higher cure rate (NS). The RR of avoiding nephrotoxicity was 1.001 (NS) and the RR of avoiding ototoxicity was 1.001 (NS). It is concluded that there is no difference concerning efficacy and safety between single-dose and multiple-dose regimes for administration of aminoglycosides.

Aminoglycosides↗
PubMed1995

24-h ambulatory blood pressure in 352 normal Danish subjects, related to age and gender.

UNLABELLED: The study was conducted to determine age and sex stratified normal values for 24-h ambulatory blood pressure. A sample of 352 healthy subjects (all white) were randomly selected from the community register and stratified by sex and age groups in decades from 20 to 79 years of age. Persons with a history of hypertension, cerebral apoplexy, diabetes, myocardial or renal disease, and who were taking blood pressure-influencing medication were excluded. Ambulatory blood pressure was recorded over 24 h, with measurements taken every 15 min from 07:00 to 22:59, and every 30 min from 23:00 to 6:59. Systolic blood pressure increased only slightly with age and was significantly higher in men than in women. The diastolic blood pressure increased only slightly with age in both sexes until the 50 to 59 years age group and declined thereafter. The diastolic blood pressure was not different for the two sexes. Both systolic and diastolic blood pressure were approximately 15% lower during the night regardless of age or sex. Ambulatory blood pressure during the daytime was on an average of 5 mm Hg lower than office blood pressure, but the mean difference between the two measurements increased with age. The variability of the difference also increased with age. IN CONCLUSION: Normal values for ambulatory blood pressure are presented in a randomly selected age- and gender-stratified population. Differences between office blood pressure and ambulatory blood pressure increased with age suggesting that the previously observed higher blood pressure seen in the elderly partly might be explained by a greater impact of white coat hypertension in older people.

Adult↗
PubMed1994

Drug interactions with intravenous and local anaesthetics.

Relatively few clinically significant drug interactions with anaesthetics have been documented in the literature. The following should be stressed since these interactions are not readily predictable or are potentially fatal. Pethidine should never be administered to patients who have received monamine oxidase inhibiting drugs within the last fortnight, since a fatal hyperpyrexia and/or hypertension may result. Thiopentone induction seems to make the heart more susceptible to arrhythmias caused by adrenergic drugs, and may cause severe arterial hypotension in patients treated with diazoxide. Midazolam orally should possibly be avoided as premedication in patients treated with erythromycin since anaesthetic concentrations of midazolam may result. Patients for whom bupivacaine analgesia is planned could preferentially be premedicated with other drugs than diazepam, which causes the serum level of bupivacaine to increase. Bradycardia and hypotension not attributable to sympathetic blockade have been reported following bupivacaine extradurally in verapamil-treated patients. Sulfonamides and the ester group of local anaesthetics, such as prilocaine in combination, may result in severe methaemoglobinaemia in infants. Epinephrine added to local anaesthetics may cause local vasodilation if administered to patients concurrently being treated with cyclic antidepressants, and the combination imposes the risk of severe hypertension and arrhythmias.

Anesthesia, Intravenous↗
PubMed1993

Drug interactions with inhalational anaesthetics.

The literature concerning the interactions between volatile anaesthetics, nitrous oxide and other compounds is reviewed. The majority are well known and most can be managed by careful dosage of the anaesthetics. The following interactions should be stressed since these are less predictable or potentially fatal. Of the cardiovascular drugs mainly the Ca++ channel blockers require attention. The volatile anaesthetics act synergistically with these drugs on the inhibition of cardiac conduction and may induce cardiac arrest. Aminoglycoside therapy should prompt an alternative to enflurane because of increased nephrotoxicity with this combination. Thiopentone induction makes the dog heart more susceptible to arrhythmias, especially during anaesthesia with volatile anaesthetics. Probably pentobarbitone, etomidate or a benzodiazepine should be preferred as an alternative to thiopentone when the use of adrenergic drugs peroperatively is anticipated. Nitrous oxide augments the sequelae after coronary air emboli and impaired cerebral perfusion in animals. The necessity of this drug should therefore be considered when anaesthetizing patients undergoing open heart surgery and patients with severe carotid or cerebral arteriosclerosis.

Anesthesia, Inhalation↗
PubMed1993

Pharmacokinetics and dynamic response of plain and slow release isradipine formulations in moderately hypertensive patients.

The pharmacokinetic variables and antihypertensive effect of the calcium antagonist isradipine, were investigated in 30 hypertensive patients. Isradipine was given orally in parallel group design in plain and slow release formulations in doses of 2.5 mg twice daily and 5.0 mg once daily, respectively. Isradipine concentration in serum was measured by a sensitive RIA method after the first dose and after 6 weeks of treatment. The pharmacokinetics and concentration/effect relationship after the first dose and after 6 weeks of treatment were compared. No differences in pharmacokinetics were observed between single and multiple dosing. Data were in accordance with results from studies in healthy volunteers. Rate, but not extent of bioavailability differs between the two isradipine formulations. Antihypertensive efficacy of the two formulations was similar (16/11 and 19/15 mmHg), and a significant time dependent increase in Emax from 10/3 mmHg to 23/14 mmHg after 6 weeks of treatment was observed.

Blood Pressure↗