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Biomedical subjects

M D Rawlins

Publications and source records attributed to M D Rawlins.

At least 73 records · Page 4Linked to original sources
PubMed1990

A double-blind placebo-controlled study of buspirone in diazepam withdrawal in chronic benzodiazepine users.

A double-blind placebo-controlled trial of 23 chronic benzodiazepine users showed that overall, buspirone did not appear to be helpful in alleviating benzodiazepine withdrawal symptoms. Buspirone (5 mg t.d.s.) or placebo was administered for four weeks before, during and after diazepam withdrawal. Patients taking buspirone had a markedly higher dropout rate (seven out of 11) than those taking placebo (one out of 12). Mean daily diazepam dosage at entry was significantly higher in the buspirone group, but overall initial diazepam dosage was not related to outcome. Higher subjectively rated anxiety at the start of withdrawal was significantly related to higher dropout rate, irrespective of treatment, and was greater (although not significantly so) in the buspirone group.

Adult↗
PubMed1989

Chemical weapons.

Explore the source record for details and available documents.

Chemical Warfare↗
PubMed1989

The effect of age upon liver volume and apparent liver blood flow in healthy man.

The aim of this study was to determine the effect of aging upon liver volume and apparent liver blood flow in healthy man. Sixty-five subjects between 24 and 91 years of age were recruited. Liver volume was quantitated by a gray scale B ultrasound scan method. Apparent liver blood flow was determined from the plasma clearance of indocyanine green, based on an assumption of no change in hepatic extraction of the dye with age. A significant negative correlation was observed between age and both liver volume and apparent liver blood flow (p less than 0.001), whether expressed in absolute terms or per unit body weight. Similarly, a significant negative correlation was observed between apparent liver blood flow per unit volume of liver (liver perfusion) and age (p less than 0.005). The reduction in liver volume, apparent liver blood flow and perfusion may at least partly account for the decline in the clearance of many drugs undergoing liver metabolism which has been noted to occur with aging in man.

Adult↗
PubMed1989

The efficacy of benorylate in postoperative dental pain.

The efficacy of a single pre-operative dose of benorylate (4 g) was determined in a double-blind, randomized, placebo-controlled parallel study in patients undergoing removal of a single impacted lower third molar. Patients treated with benorylate 4 g reported significantly less pain between 3-6 h after dosage than those treated with placebo. Overall pain scores at 6 h were significantly less in the benorylate group than the placebo group. However, overall pain scores at 12 h did not differ significantly between treatment groups. It is concluded from this study that a single dose of benorylate 4 g given immediately prior to the removal of an impacted lower third molar provides limited pain control during the postoperative period.

Acetaminophen↗
PubMed1989

Plasma aspirin esterase: the influence of old age and frailty.

Plasma aspirin esterase activity, expressed as nmol salicylate formed/ml plasma/min, was found to be similar in a group of healthy elderly adults, a group of young adults and a group of frail young adults, but was lower in a sample of frail elderly subjects. This was associated with reduced plasma albumin levels in healthy elderly subjects compared with young subjects and levels were lower still in the frail elderly group. Plasma cholinesterase also showed a trend towards reduced activity in the frail elderly subjects. As plasma aspirin esterase activity may influence the amount of circulating aspirin, these changes may have implications for the use of aspirin in frail elderly people.

Adult↗
PubMed1989

The relation of age to the acute effects of ethanol on acetanilide disposition.

The activity of the major drug-metabolizing enzymes, the mono-oxygenases, can be inhibited by an acute dose of ethanol. We set out to determine whether age has any relation to the degree of inhibition produced by ethanol, using acetanilide as a model substrate. Eight healthy young subjects (mean age 26 years) and eight healthy elderly subjects (mean age 72 years) were studied on two occasions, once receiving acetanilide alone and once acetanilide with 75 ml vodka (30 g ethanol). The clearance of acetanilide was significantly lower (p less than 0.05) in the elderly subjects at 27 +/- 3 l/h compared to 38 +/- 2 l/h in young subjects. No age-related differences in peak blood ethanol concentrations or ethanol elimination rates were noted. After ethanol, acetanilide clearance fell 18% to 31 +/- 3 l/h in young subjects (p = 0.05) and by 15% to 23 +/- 2 l/h in elderly subjects (p = 0.08). This suggests that the elderly do not suffer greater impairment of drug oxidation after acute ethanol ingestion than do the young.

Acetanilides↗
PubMed1989

The effect of age and frailty upon acetanilide clearance in man.

Six healthy young subjects (aged 23-32 years), six healthy elderly subjects (over 60 years) and six hospitalized long-stay geriatric subjects over 60 years received single oral doses of acetanilide. Acetanilide clearance was similar in the fit and frail elderly subjects at 26.4 +/- 2.5 and 26.3 +/- 3.6 l/h and significantly lower (p less than 0.05) than in the young subjects at 39.0 +/- 1.9 l/h. Liver volumes, measured by ultrasound, were significantly less in the elderly than in the young subjects, whether expressed in absolute terms or per unit body weight (p less than 0.05). When acetanilide clearance was expressed per unit volume of liver, no change occurred with age or frailty. These results suggest that a reduced liver size may be an important contributor to the reduced elimination of capacity limited drugs in elderly man.

Acetanilides↗
PubMed1989

Benorylate hydrolysis by human plasma and human liver.

1. Benorylate (4-acetamido phenyl-O-acetylsalicylate) hydrolysis in vitro by human plasma and by human liver microsomes and cytosol has been investigated. 2. Benorylate was hydrolysed by a route involving initial hydrolysis of the acetyl group to yield phenetsal followed by hydrolysis to paracetamol and salicylate. Hydrolysis via acetylsalicylate was minor. 3. Benorylate was more actively hydrolysed by liver cytosol than microsomes and about 10 times faster than plasma. 4. Following a single oral dose benorylate (4 g) to volunteers only salicylate and paracetamol were detected in the plasma. 5. The therapeutic effects of benorylate appear to be mediated by salicylate and paracetamol.

Acetaminophen↗
PubMed1989

The effects of intradermal bradykinin are potentiated by angiotensin converting enzyme inhibitors in hypertensive patients.

1. To test the hypothesis that angiotensin converting enzyme (ACE) inhibitors potentiate the tissue effects of bradykinin, the thickness of weals produced by intradermal injections of bradykinin was measured in 17 hypertensive subjects whose antihypertensive regimen included an ACE inhibitor, and in 12 whose treatment did not. 2. Weal thickness increased linearly with the logarithm of the bradykinin dose in both groups (P less than 0.0001). 3. The patients receiving ACE inhibitors showed a mean response of 1.18 +/- 0.08 mm (mean +/- s.e. mean), compared with a mean response of 0.75 +/- 0.08 mm for patients not receiving an ACE inhibitor (P = 0.002). Mean weal response (1.08 +/- 0.9 mm) was not significantly different in patients taking captopril (n = 11) compared with that (1.29 +/- 0.12 mm) in patients taking enalapril (n = 9). 4. Facial flushing during the experiment occurred in six patients taking ACE inhibitors but none who were not. 5. Dermal responses to bradykinin are enhanced in patients taking ACE inhibitors as routine antihypertensive therapy. This study supports the hypothesis that bradykinin may be responsible for some of the adverse effects of these drugs.

Adult↗
PubMed1989

Human liver and plasma aspirin esterase.

The plasma, in addition to the liver, is a major site of hydrolysis of aspirin. Human plasma and liver aspirin esterase activities in samples from a group of patients varied over a two fold range and there was a significant correlation between individual plasma and liver activities. Human liver aspirin esterase was present in the cytosolic and microsomal fractions. Cytosolic and microsomal enzymes had different activities and apparent affinities for aspirin.

Aged↗
PubMed1989

Extrapyramidal reactions to metoclopramide and prochlorperazine.

We have investigated prospectively the incidence of extrapyramidal events amongst patients receiving 'first' prescriptions for metoclopramide (n = 2557) and prochlorperazine (n = 2811) from general practitioners in the Northern Region using community pharmacists to capture prescriptions. There were 12 reports of acute dystonic-dyskinetic events following metoclopramide and the incidence of this reaction was significantly greater in those under 30 years than in those 30 years and over. Following prochlorperazine there were eight reports of Parkinsonism in patients whose ages were known; seven were over 60 years. The incidence in those over 60 years was significantly higher than in those less than 60 years.

Adolescent↗
PubMed1988

The acute and subchronic effects of ketoconazole on hepatic microsomal monooxygenases in the rat.

Female adult Wistar rats were treated with single or repeated doses of ketoconazole ranging from 10 mg/kg to 100 mg/kg. Single dose treatment produced inhibition of hepatic microsomal ethoxyresorufin O-deethylation (EROD) and aldrin epoxidation (AE) 2 hr after oral dosing. Twenty-four hours after a single dose, inhibition was still demonstrable after the low dose of 10 mg/kg, but at higher doses increased microsomal activity was apparent. After 7 days repeated dosing liver weight and microsomal protein content were increased in a dose-dependent fashion. EROD and AE were induced at all doses after repeated treatment when the increase in liver size was considered. These effects were seen at doses within the antimycotic therapeutic range and add support to the suggestion that reported drug interactions with ketoconazole in man are due to the effects of this drug on hepatic microsomal activity.

Animals↗
PubMed1988

The effects of two different dental local anesthetic solutions on plasma potassium levels during third molar surgery.

The influence of two different dental local anesthetic solutions on plasma potassium levels during third molar surgery has been investigated in a single-blind cross-over study in twelve volunteers. The solutions employed were 2% lidocaine (xylocaine) containing 1:80,000 epinephrine and 3% prilocaine (Citanest) containing 0.03 IU/ml felypressin. The different treatments produced similar effects on blood pressure and heart rate. However, the effect on plasma potassium levels differed significantly in the early postinjection period.

Adult↗