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Biomedical subjects

P Hermann

Publications and source records attributed to P Hermann.

At least 55 records · Page 3Linked to original sources
PubMed1988

Possible interactions between zolpidem, a new sleep inducer and chlorpromazine, a phenothiazine neuroleptic.

The combined use of a hypnotic and a neuroleptic is a rather frequent situation, encountered especially in the psychiatric sphere. We therefore tested zolpidem and chlorpromazine in six healthy subjects by using a double-blind latin square design. All of them received single doses of 20 mg zolpidem (ZOL), 50 mg chlorpromazine (CPZ) and the combination of ZOL + CPZ. The medication was given as a single dose in the morning and each treatment being separated by a 1-week interval. Zolpidem produced moderate to severe sedation varying according to the subjects. Psychometric performances (manual dexterity, Stroop test), alertness and psychomotricity (visual analogue scales) were reduced up to 3 h after drug intake. Chlorpromazine alone did not have much effect. Combined administration of ZOL and CPZ was rather more effective than ZOL alone. The pharmacokinetics of ZOL or CPZ remained unchanged except for the elimination half-life of CPZ, which increased significantly when administered along with ZOL. No other pharmacodynamic or pharmacokinetic interaction between ZOL and CPZ was evident. The fact that the ZOL and CPZ combination accentuated the pharmacodynamical effects can be explained to result from the summation of each of their own pharmacological effect.

Adult↗
PubMed1988

Epidemiological survey of the "natural" mortality in psychiatry.

The authors reviewed articles published from 1838 dealing with excess of "natural" mortality in psychiatric "in-" and "out" patients. The high natural mortality rate has always existed and is still observed today despite the quality of somatic care. The excess is observed in every country, ethnic group, sex, age or site of treatment but does not seem to be associated with specific organic pathology. The risk of "natural" mortality (suicide and accidents excluded) remains 2 to 5 times greater than in normals. Hypotheses concerning the phenomenon are reviewed or suggested.

Adult↗
PubMed1988

Lack of interaction between zolpidem and H2 antagonists, cimetidine and ranitidine.

Zolpidem is a new imidazopyridine derivative acting as a hypnotic which may be prescribed with H2 receptor antagonists in patients with peptic ulcer. A cross-over study (cimetidine, 1 g daily for 19 days; ranitidine, 300 mg daily for 19 days; wash-out period: 20 days) was carried out in six healthy volunteers. Zolpidem, 20 mg was administered orally at 09h00 prior to any treatment and on days 2 and 17 of each treatment period. Antipyrine clearance was also determined before and on day 18 of each treatment period. Under these experimental conditions, the inhibitory effect of cimetidine on the Cyt P-450 mono-oxygenase system has been demonstrated (reduced clearance of antipyrine, p less than 0.01) but the pharmacokinetics of zolpidem did not appear to be modified. Zolpidem induced hypnotic effects for the first 3 h which tend to be prolonged by the combination with cimetidine. Psychometric and pharmacokinetic evaluations did not show significant interactions with either anti-H2 receptor agent following zolpidem administration.

Adult↗
PubMed1988

Influence of salts on the covalent immobilization of proteins to modified copolymers of 2-hydroxyethyl methacrylate with ethylene dimethacrylate.

In the study of the covalent immobilization of aminoacylase, thermitase, pepsin, trypsin, chymotrypsin, elastase, subtilisin, penicillinamidohydrolase, carboxypeptidase A, cystathionine-beta-synthase, and anticathepsin D-IgG to copolymers of 2-hydroxyethyl methacrylate and ethylene dimethacrylate (Separon HEMA) containing epoxy groups a marked influence of added salts on the immobilization efficiency was observed. Yields in covalently bound active enzymes were dependent on the concentrations and type of ions added, which can be arranged according to the Hofmeister series. At a distinct concentration, the salting-out ions cause a protein-matrix hydrophobic interaction which is a prerequisite for the covalent bond formation.

Cross-Linking Reagents↗
PubMed1986

Tyrosine loading in patients with hepatic cirrhosis: lack of effect on plasma catecholamines.

Plasma norepinephrine concentrations are often elevated in patients with hepatic cirrhosis in relation to the stage of disease and possibly in response to a decrease in "effective" arterial blood volume. Since tyrosine, the precursor for catecholamines, is said to influence the rate of catecholamine biosynthesis within the central nervous system and peripheral sympathetic structures, we tested whether basal hypertyrosinemia and increased plasma tyrosine levels after oral loading with l-tyrosine are associated with elevated plasma catecholamine concentrations. Baseline norepinephrine (NE) and epinephrine (E) were significantly higher in 17 patients with decompensated cirrhosis, as compared with 11 healthy controls (NE: 809 +/- 108 pg/ml vs 295 +/- 16 pg/ml; E: 69 +/- 9 pg/ml vs 36 +/- 8 pg/ml). No significant correlation between the basal plasma tyrosine and norepinephrine level could be demonstrated in patients with cirrhosis (r = 0.04). Oral tyrosine loading (100 mg/kg b.w.) administered in six equal doses did not change the level of catecholamines, whereas plasma tyrosine increased two- to three-fold. Even a large single dose (14 g l-tyrosine) failed to alter plasma catecholamines in six cirrhotic patients with marked ascites. We therefore conclude that the enhanced availability of tyrosine in cirrhotics does not influence catecholamine biosynthesis in peripheral sympathetic neurons.

Blood Pressure↗
PubMed1986

[Circadian neuroendocrinologic profile in patients with multiple drug abuse].

13 cases of politoxicomania that had undergone stationary treatment and, at the time of observation, were in rehabilitation, comprised the case load of this study. They were compared with 10 test persons in good state of health. In order to obtain circadine hormone profiles for melatonine, cortisol, human growth hormones (HGH) and thyroid stimulating hormones (TSH), blood samples were taken every hour from 6 pm until 7 am the following morning. The test cycle commenced with obtainment of a biochemical blood profile and a drug-oriented urine analysis. The cases were assorted into three therapy groups: Group 1: complete abstinence. Group 2: no hard drug intake. Group 3: acute relapse after a prolonged period of abstinence. This categorization (i.e. abstinence, soft or hard drug intake) was clearly mirrored by significant differences in the hormone profiles: the group of "abstinents" showed remarkably higher melatonine and cortisole levels than the acute relapsive cases. HGH and TSH profiles showed partly pathological levels which appeared unrelated, however, to the incidence of abstinence, or the manner of drug intake. Compared to the healthy control group, the test cases showed an increase of liver enzymes (Gamma-GT, SGOT, SGPT and LDH) but there was no marked difference between the 3 user categories themselves. The pathological neuroendocrine findings identified in test patients after a long period of abstinence are indicative of changes possibly based on genetic disposition rather than on abusive habits. The issue of self-inflicted damage, therefore, becomes a questionable one.

Adult↗
PubMed1985

Pharmacokinetics of diltiazem and other calcium entry blockers.

Diltiazem, as well as other calcium entry blockers, is widely prescribed for the treatment of various types of angina. This review summarizes the current state of knowledge of the pharmacokinetics of diltiazem and of two other calcium entry blockers: verapamil and nifedipine. Although unrelated in their chemical structure, these three drugs have common features. They are highly lipophilic and have a large volume of distribution, are mainly cleared by metabolism and undergo an extensive first-pass extraction. On the other hand, as expected from their quite dissimilar structures, they have their own particular kinetic characteristics. For example, metabolism of diltiazem and verapamil gives rise to active metabolites; repeated administration influences the kinetic profile of verapamil but not those of diltiazem and nifedipine. Absorption, distribution and elimination of these three drugs are differently affected by age and pathological conditions. The possible drug interactions involving diltiazem and the other calcium entry blockers are discussed, particularly that with digoxin. Due to its large therapeutic index, there is no need for treatment monitoring of diltiazem. Nevertheless, this procedure may provide useful information for optimizing the dosage regimen of each patient as the pathological condition and drug therapy may be quite complex.

Administration, Oral↗
PubMed1984

Determination of betaxolol, a new beta-blocker, by gas chromatography mass spectrometry: application to pharmacokinetic studies.

Betaxolol, a beta selective adrenoceptor antagonist recently approved for the treatment of hypertension, was determined by monitoring in chemical ionization mode with ammonia the [MH]+ ions of the trimethylsilyl derivatives of the drug and of its internal standard [2H5)betaxolol). Its pharmacokinetic profile obtained following administration of a 20 mg oral dose was characterized by a half-life of 22 h and a bioavailability of 85%. The main acid metabolite formed by elimination of the isopropylamino group may also be determined as the methyl TMS derivative but methylation with BF3-methanol should be used with caution since it may induce the opening of the cyclopropyl group. The routine electron capture determination procedure was compared to this mass spectrometric method and an excellent correlation was found (r = 0.9974). Both procedures have the same sensitivity (1 ng ml-1). Finally it was observed that under electron impact mode betaxolol trimethylsilyl side chain rearranged to lose TMS-O-CH=CH2; this elimination was confirmed by deuterium labelling studies.

Adrenergic beta-Antagonists↗
PubMed1983

[Clonidine for the treatment of heroin withdrawal syndrome].

In an open study of 50 patients with heroin addiction, clonidine was efficacious by mouth in the treatment of acute heroin-withdrawal syndrome. Mean administration of clonidine (on an "as-needed" basis) was 5 days (maximum 7 days), whilst the mean daily dosage ranged from 0.112 mg to 0.468 mg, the maximum requirement occurring on day 2 of withdrawal and sinking thereafter. Since insomnia was not influenced by clonidine, we offered 100 mg doxepine and/or 10 mg nitrazepam (the latter only until day 4 of treatment). Under this medication a sudden, dramatic decrease in blood pressure was not seen, mean blood pressure and pulse rate were not markedly altered; this may, perhaps, be a consequence of the blocking effect of doxepine on the peripheral hypotensive actions of clonidine. Of the 9 drop-outs from treatment, five (10% of the total 50) were certainly directly attributable to the lack of response to clonidine, representing a failure of therapy in 10% cases at least.

2-Hydroxyphenethylamine↗
PubMed1983

Pharmacokinetics of diltiazem after intravenous and oral administration.

The kinetic profile of diltiazem, a novel calcium antagonist, was studied in 12 volunteers following oral (60 mg) and intravenous (15 mg) administration. After i.v. administration biphasic elimination was observed, with a distribution half-life of 0.3 +/- 0.2 h and an elimination half-life of 3.1 +/- 1.0 h; the apparent volume of distribution was 5.3 +/- 1.71/kg and the total clearance was 1.28 +/- 0.48 l/kg/h. After the oral dose the elimination had a half-life of 3.2 +/- 1.3 h. The absolute bioavailability of diltiazem ranged from 24 to 74% (mean 42 +/- 18%). The interindividual variation may be explained by a variable first pass effect.

Administration, Oral↗
PubMed1983

[Inpatient withdrawal treatment of heroin dependence with neuroleptics--an approach to addicts].

The authors present a setting for abrupt withdrawal treatment with the following targets: 1. To facilitate the addicts the voluntary use of medical and psychiatric service. 2. To develop methods for withdrawal treatment, as riskless and easy to handle as possible. 3. To use the time of inpatient treatment for building up confidence in psychiatric services to motivate the patients for a following therapy. Drugs and dosage of peroral and intravenous neuroleptic treatment and possible complications are discussed. Peroral treatment has the advantage of lower doses, easier handling and lower complication rates. The setting and the used drugs seem to be attractive enough for many addicts to contact the clinic on their own account.

Administration, Oral↗
PubMed1982

[In-patient withdrawal treatment of heroin addicts with neuroleptics (author's transl)].

The results are reported of 144 abrupt withdrawal treatment in heroin addicts (102 in males, 42 in females). Neuroleptics were given intravenously (partly via subclavia catheter) or orally and the results compared with one another. Parenteral treatment needed much more specialist supervision and control and had a much higher complication rate. It should be used only on the individual special case. The initial withdrawal lasts about 4 days with an oral dosage of 270 mg levopromazine in males and 240 mg in females or 540 mg chlorprothixene in males and 520 mg in females per 24 hours. The only side effects encountered were tachycardia and the occasional occurrence of extrapyramidal signs. The liver function tests did not show any significant changes during the treatment.

Adolescent↗
PubMed1981

[Excess mortality in out-patients psychiatry: first results of a Geneva study].

The project intends to prove an excess of mortality among the out-patients of the official psychiatric center of Geneva. The study is of the follow-up retrospective type. The primary results confirm the hypothesis. They show an increased relative risk of death by suicide and other non natural causes, for both sexes, as well as by natural causes (especially respiratory diseases) but only among women.

Adult↗