Biomedical subjects
M D Rawlins
Publications and source records attributed to M D Rawlins.
Widespread atheromatous arterial disease.
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Treatment of second-degree heart block.
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Hepatic drug acetylation and oxidation: effects of aging in man.
The half lives of acetanilide and isoniazid ("model" substrates for oxidation and acetylation respectively) were measured in populations of young (aged 20-35 years) and elderly (aged over 65 years) people. Whereas acetanilide half lives were significantly longer in the elderly, isoniazid half lives were distributed similarly in both populations. The results suggest that liver function does not decline uniformly with age and that heterozygotes for acetylation do not possess survival advantages during their middle years of life.
Clinical pharmacology clinics in general practice.
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Pharmacokinetics of paracetamol (acetaminophen) after intravenous and oral administration.
Plasma paracetamol concentrations were measured in 6 volunteers after single intravenous (1000 mg) and oral (500 mg, 1000 mg and 2000 mg) doses of the drug. Paracetamol levels declined multiphasically with a mean clearance after intravenous administration of 352 +/- 40 ml/min. A two-compartment open model appeared to describe the decline adequately. Comparison of the areas under the plasma concentration-time curves (AUC) indicated that oral bioavailability increased from 0.63 +/- 0.02 after 500 mg, to 0.89 +/- 0.04 and 0.87 +/- 0.08 after 1000 mg and 2000 mg, respectively. As a consequence of the incomplete bioavailability of paracetamol, as well as its multicompartmental distribution, accurate estimates of its distribution volume and clearance cannot be obtained if the drug is given orally. However, an estimate of its total plasma clearance may be derived from the AUC after a 500 mg oral dose.
Antiarrhythmic action of lignocaine in early myocardial infarction. Plasma levels after combined intramuscular and intravenous administration.
In an attempt to find a regimen suitable for pre-hospital prevention of arrhythmias following myocardial infarction, the antiarrhythmic and pharmacokinetic effects of combining intravenous and intramuscular lignocaine have been studied. In nine patients with acute myocardial infarction, 100 mg of lignocaine was administered intravenously and 300 mg into the deltoid muscle. The antiarrhythmic effect was observed by continuous tape monitoring of the patients' rhythm before and after treatment. Plasma levels above 2 microng/ml were achieved within 1 min and maintained for 1 h in all patients; in seven this level was maintained for 2 h. A marked reduction in the occurrence of ventricular ectopic beats was observed in the first 15 min after treatment and was maintained for 90 min, but a significant effect was still present at 3 h. No serious side-effects were noted.
Dose-titrated, double-blind, cross-over comparison of a selective beta-blocker and methyldopa in the treatment of hypertension.
The efficacy and toxicity of tolamolol and methyldopa in hypertensive patients has been compared by a dose-titrated, double-blind, cross-over study. Thirteen patients completed the trial. Within the dose ranges investigated (tolamolol - 300 mg/day - 900 mg/day; methyldopa - 750 mg/day - 2250 mg/day)both drugs produced significant falls in laying and standing, systolic and diastolic blood pressures. Although the hypotensive effects of methyldopa were more marked than tolamolol, these only achieved conventional (P less than 0.05) levels of significance for lying blood pressure. There were no objective changes in haematological or biochemical indices during treatment with either drug, but patients complained of tiredness, weak limbs and mouth dryness significantly more during methyldopa treatment, than during either placebo or tolamolol therapy.
Comprehensive clinical drug information service: first year's experience.
A comprehensive clinical drug information service, established in the Northern Region in May 1975, is manned by eight doctors--all clinical pharmacologists--and is available 24 hours a day. In the first year of operation 451 inquiries were received, 354 (78-5%) of which were "consultative." Though junior hospital doctors used the service most, almost half of the inquiries about adverse reactions to drugs came from consultants.
Monitoring adverse reactions to drugs.
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Monoamine metabolites in cerebrospinal fluid during treatment with clonidine or alprenolol.
Lumbar cerebrospinal fluid (CSF) concentrations of the major metabolites of noradrenaline (4-hydroxy-3-methoxyphenyl glycol, HMPG), serotonin (5-hydroxyindoleacetic acid) and dopamine (homovanillic acid) were measured before and during the administration of clonidine or alprenolol to hypertensive patients. The noradrenaline receptor stimulant clonidine significantly decreased the CSF level of HMPG, but there was no consistent change in the concentration of serotonin or dopamine metabolites. Patients on alprenolol showed no change in the levels of these metabolites in CSF.
The role of the pharmaceutical industry in postgraduate medical education.
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Drug information centres: a clinical pharmacologist's view.
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Activity of aryl hydroxylase in adult human skin [proceedings].
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Factors affecting anticoagulant response [proceedings].
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