Biomedical subjects
N Buchanan
Publications and source records attributed to N Buchanan.
Hycanthone--a danger associated with its use.
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Drug-protein binding and protein energy malnutrition.
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The binding of phenobarbitone and phenytoin to kwashiorkor serum.
The binding of phenytoin and phenobarbitone to the serum of kwashiorkor patients and normal serum has been investigated. There was no alteration in the binding of phenytoin. However, there was a decrease in the binding of phenobarbitone to kwashiorkor serum, and this was particularly striking in the presence of added phenytoin. It was confirmed that phenytoin was almost exclusively albumin-bound, while phenobarbitone was bound to albumin, alpha 1-and alpha 2-globulin in almost equal proportions.
The binding of antituberculous drugs to normal and kwashiorkor serum.
The protein binding of 6 antituberculous drugs--ethambutol, ethionamide, isoniazid, para-aminosalicylic acid, rifampicin and streptomycin--to normal and kwashiorkor serum has been investigated. The binding of these drugs was mildly decreased in kwashiorkor serum, but not to such an extent as to be of therapeutic importance, except for streptomycin and possibly para-aminosalicylic acid (PAS). With streptomycin there was a 15% increase in the free component in kwashiorkor serum, while with PAS there was a 12% increase in the free component. Of interest is the observation that rifampicin is predominantly bound to the gamma-globulin fraction, both in normal and in kwashiorkor serum. Secondary binding, predominantly to the alpha 1-, alpha 2-and gamma-globulin fractions, was seen quite commonly in kwashiorkor serum in association with diminished albumin binding.
The metabolism of phenobarbitone, phenytoin and antipyrine in Black patients.
The half-lives of phenytoin, phenobarbitone and antipyrine were studied in adult Black patients to attempt to ascertain the cause of low phenytoin concentrations previously found in Black epileptics. The following half-life values were observed: antipyrine 5,7 +/- 1,9 hours, phenytoin 15,9 +/- 7,9 hours, phenobarbitone 63,0 +/- 18,2 hours, and phenytoin after 1 month of phenobarbitone therapy 31,5 +/- 11,9 hours. No explanation was obtained for the low phenytoin levels previously observed.
Problem in prescribing for ambulatory Black children.
A study to assess patient, pharmacist and physician compliance was carried out in a group of 200 ambulatory Black children. Patient non-compliance was observed in 45.5% of instances, and physician non-compliance in 62.5%, while non-compliance on the part of pharmacists was trivial. Other problems, such as inappropriate prescribing and an apparent lack of communication between physician and pharmacist, came to light. These observations are discussed and a series of recommendations are proposed.
A socio-economic, health and cultural survey in Soweto.
The socio-economic, health and nutritional status of 186 families in Diepkloof, Soweto, was studied. The results, detailed in the text, reveal considerable socio-economic ills, of which the most important is the observation that 30% of the families existed below the poverty datum line, even when there was more than one wage-earner. More emphasis on health education and the promotion by health personnel of a better understanding of the backgrounds of clinic and hospital patients are urgent priorities for health services.
Serum levels of anticonvulsants and haematological sequelae in black epileptics.
Serum levels of phenytoin and phenobarbitone were studied in a group of Black adult epileptics. Therapeutically satisfactory levels of phenytoin were observed in only 11,3% of patients, and of phenobarbitone, in 63,9%. An overall non-compliance rate of about 50% was noted. The possible reasons for this are discussed. Folate deficiency was not a major problem in this group of patients.
A laboratory investigation into bilirubin binding in neonates.
The presence of free bilirubin the serum of 59 Black neonates was studied at the time of exchange transfusion with an electrophoretic technique. It was observed that 32 infants had detectable free bilirubin in their serum and that these infants had a significantly greater bilirubin/albumin ratio that infants without free serum bilirubin.
Athetosis and phenytoin toxicity.
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Symmetrical gangrene of the extremities associated with the use of dopamine subsequent to ergometrine administration.
The occurrence of symmetrical gangrene of all 4 extremities after the use of dopamine, subsequent to the administration of egometrine, is described. It is suggested that the concomitant use of these 2 agents should be avoided.
Gastrointestinal absorption studies in cardiac cachexia.
The nutritional status of 11 patients with severe mitral valve disease was investigated pre-operatively and 3 months post-operatively. It was shown that they were malnourished pre-operatively, and that this appeared to be related mainly to anorexia.
Pulmonary oedema associated with hydrocarbon inhalation.
A patient with gross pulmonary oedema secondary to inhalation of paint fumes is described. Treatment with mechanical ventilation and positive end expiratory pressure was required.
Warfarin binding in kwashiorkor.
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Chloramphenicol binding to normal and kwashiorkor sera.
The binding of chloramphenicol to normal and kwashiorkor sera was investigated in vitro. Chloramphenicol is predominantly albumin bound, although a significant degree of binding to the other major protein fractions occurs. From the clinical view point, a decreased degree of binding of kwashiorkor serum (+/-5%) is not of significance.
The binding of thiopentone to kwashiorkor serum.
The binding of thiopentone to normal and kwashiorkor serum has been investigated. It has been confirmed that thiopentone is bound to albumin predominantly. In kwashiorkor serum, less binding to albumin occurs, but secondary binding sites appear. The significance of these observations is discussed.