Biomedical subjects
Publications and source records attributed to M K Meeran.
A 39-year-old woman who suffered from migraine is described. She developed analgesic nephropathy due to phenacetin, and constrictive pericarditis, probably due to methysergide treatment.
This report describes a patient with an epicardial demand pacing system in whom pacing failure two months after implantation was found to be due to a fracture of the helical wire electrode within its supporting structure. We know of no report of this site of failure of a Cordis 323-451 or similar electrode.
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The magnitude and duration of effect of a single 40-mg oral tablet of oxprenolol on the tachycardias associated with motor-car driving, isoprenaline infusion, and walking were compared against placebo in six normal people by a double-blind study. The tachycardias due to driving and isoprenaline were both conspicuousy reduced for over eight hours; the magnitude and duration of the reduction in exercise tachycardia was substantially less. Thus relatively small doses of beta-receptor antagonists will suppress the increase in heart rate induced by mental stress or catecholamines with relatively little effect on the response to everyday exercise. Possibly smaller doses of these drugs would relieve emotionally-induced anginal pain and tachycardia.
The symptomatic, electrocardiographic, and circulatory effects of intravenous and oral preparations of propranolol, oxprenolol, and practolol were compared in 16 patients with uncomplicated angina pectoris precipitated by exertion. The method of study included treadmill exercise, double-blind assessment, single-blind analysis, with placebo control and randomized serial comparison of each drug in each patient. The doses used were selected to give the same near-maximum suppression of the heart rate response to exercise. The symptomatic, electrocardiographic, and circulatory response of each patient to both preparations of each of the three drugs was similar. Exercise tolerance was increased in two-thirds, unchanged in one-sixth, and significantly worsened in one-sixth of the studies. Electrocardiographic evidence of myocardial ischaemia was conspicuously reduced by all three drugs in most studies irrespective of their symptomatic effects. Though the exclusive choice of patients, the single dose design of the trial, and the treadmill method of assessment limit the general application of these results, they do clearly indicate that in doses that induce equal suppression of the exercise heart rate these three drugs have similar distinct anti-anginal activity. Their ancillary pharmacological properties are probably of little importance in this respect. Equally, the similarity in the symptomatic, circulatory, and electrocardiographic response to the intravenous and oral preparations suggests that metabolic breakdown products are probably of therapeutic importance only in so far as they antagonize beta-receptor activity.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
The symptomatic, electrocardiographic, and haemodynamic effects of two adrenergic beta-blocking drugs, oxprenolol and propranolol, have been compared in equipotent intravenous doses in six patients with uncomplicated angina pectoris during treadmill exercise. The method of comparison included double-blind assessment and analysis with placebo control and randomized serial comparison in each patient. Both drugs produced an equal amelioration in symptoms in most of the patients. This was closely correlated with improvement in the electrocardiographic changes and a significant reduction in the exercising heart rate and systemic arterial pressure. This method of double-blind combined subjective and objective assessment carries distinct advantages in the comparative assessment of drug treatments in angina pectoris.
This case report describes a 23-yr-old woman with Crohn's disease who developed sinus bradycardia 4 hr after initiation of total parenteral nutrition with lipids through a peripheral vein. The bradycardia persisted for 1 wk, with only slight improvement when the lipids were held for two 4-hr periods. The heart rate began to improve when lipids were changed from 10 to 20%, and continued to rise after Synthroid was started. The possible relationships between nutritional and thyroid status, as well as lipids and heart rate are discussed.