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Biomedical subjects

P Crome

Publications and source records attributed to P Crome.

At least 73 records · Page 4Linked to original sources

Experience with activated carbon-bead haemoperfusion columns in the treatment of severe drug intoxication. A preliminary report.

Five patients who were severely poisoned with hypnotic drugs, paracetamol, or theophylline were treated by charcoal haemoperfusion. The device contained 160 g of activated carbon beads with a polyester coating. Four patients made a significant improvement; one subsequently died from a cerebral haemorrhage which had occurred prior to haemoperfusion. Platelet losses were minimal and no fibrinolysis was observed. No significant biochemical abnormality occurred as a result of haemoperfusion, although one patient, who presented with hypocalcaemia, required intravenous calcium throughout the procedure.

Acetaminophen↗

Assessment of a new calendar pack--the 'C-Pak'.

Seventy-eight elderly patients in hospital were studied for up to four weeks to assess drug compliance. Forty patients received medication from individualized calendar packs ('C-Pak') and 38 received medication from standard bottles. There was no difference in compliance between the two groups, the percentage error for each group being 26%. This result suggests that C-Pak is unlikely to improve drug compliance in unselected elderly patients.

Aged↗

Nortriptyline therapy in elderly patients: dosage prediction from plasma concentration at 24 hours after a single 50 mg dose.

Ten depressed elderly female patients in hospital (mean age 82 years) received a single oral dose of 50 mg nortriptyline prior to commencing treatment with this drug. The nortriptyline concentration in a plasma sample obtained 24 hours afterwards was used to predict the daily dose required to achieve a steady-state concentration within the range of 50-150 micrograms. l-1. The mean daily dose prescribed was 50 mg (range 20-100 mg). These dosage regimes provided a mean observed steady-state nortriptyline concentration of 104 micrograms. l-1, with a range of 76-180 microgram. l-1 (S.D. 30 microgram. l-1). Use of this prediction test can prevent the development of toxic plasma concentrations and enhance the possibility of therapeutic success.

Aged↗

[Depressed patients and their treatment. Therapeutic mistakes and toxicity (author's transl)].

Prescribing tricyclic antidepressants presents potential hazards to patients with heart disease, glaucoma, prostatic hypertrophy and epilepsy for their symptoms may be aggravated. Mianserin, on the other hand, has little effect on the heart and the parasympathetic nervous system and this drug may be used safely in these circumstances. Tricyclic antidepressants and mianserin also differ in their toxicity when taken in overdose. Poisoning with mianserin rarely causes more than drowsiness except when other drugs have been taken. In contrast overdose with tricyclic antidepressants frequently causes epileptic convulsions, arhythmias, hypotension, and anticholinergic signs. Death occurs in 2-3% of overdoses, usually due to cardiovascular collapse, respiratory depression or status epileptic's either alone or in combination.

Antidepressive Agents↗

Experience with fixed-bred charcoal haemoperfusion in the treatment of severe drug intoxication.

Fifteen patients who were severely poisoned with either hypnotic drugs or salicylate were treated by charcoal haemoperfusion. The device contained 100g of activated charcoal immobilised by fixation to a polyester film. Two patients showed no response and eventually died. The remainder showed marked lightening of coma and recovered uneventfully. Complications of platelet loss and, in one patient, fibrinolysis were observed, but these had no serious consequences. No significant biochemical disturbances occurred with the exception of one patient who presented with hypocalcaemia and required intravenous calcium throughout the treatment. Drug clearance values were comparable with those obtained with columns containing 300 g of acrylic polymer coated charcoal.

Adolescent↗

Experience with cellulose acetate-coated activated charcoal haemoperfusion in the treatment of severe hypnotic drug intoxication.

A haemoperfusion column containing activated charcoal coated with cellulose acetate was used to treat 7 patients with barbiturate or ethchlorvynol poisoning. Six of the patients showed marked lightening of coma and all showed a significant fall in plasma drug concentration. Plasma drug clearance and platelet loss were similar to those reported for other coated charcoal columns. Cellulose acetate-coated charcoal haemoperfusion may reduce the period of coma in severe poisoning with barbiturates and other hypnotic drugs and thus the morbidity and mortality.

Adult↗