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Biomedical subjects

R A Moore

Publications and source records attributed to R A Moore.

At least 235 records · Page 13Linked to original sources
PubMed1982

Sublingual buprenorphine used postoperatively: ten hour plasma drug concentration analysis.

1 A 10 h study of plasma drug concentrations of the opiate buprenorphine after use was designed because a previous 3 h study had shown that peak plasma drug concentrations in some patients had not occurred by 3 h after the sublingual dose. 2 Fifteen postoperative patients were studied: at 3 h after a 0.3 mg intravenous dose five patients received a sublingual preparation of 0.4 mg of buprenorphine, five 0.8 mg of buprenorphine and five placebo. Plasma drug concentrations of buprenorphine were measured by specific radioimmuno-assay. 3 Plasma drug concentrations after sublingual buprenorphine were significantly higher than those in the placebo group by 1 h. They remained significantly higher over the succeeding nine hours. The mean time to peak plasma drug concentration was about 200 min in both the 0.4 mg and 0.8 mg groups (range 90-360 min). The plasma drug concentrations in the 0.8 mg group were approximately twice those in the 0.4 mg group; the ratio of the relative systemic availabilities was similarly 1.8:1. The absolute systemic availability was estimated at about 55% for both groups. Uptake of buprenorphine from the sublingual site was essentially complete by 5 h after the dose was given. 4 The implications for the timing of sublingual doses in clinical use are discussed.

Aged↗
PubMed1982

Some patients don't need analgesics after surgery.

Postoperative analgesic requirements of 410 patients undergoing elective orthopaedic limb surgery were studied. Premedication and anaesthetic were standardized with no narcotic. Twenty-three patients required no analgesic at all during their hospital stay. The importance of acknowledging the existence of this group of patients is discussed. The distribution of time to first analgesic requirement for the other patients was obtained. The importance of knowing the distribution for particular operative procedures and the effect of analgesic interventions such as premedication is discussed.

Adolescent↗
PubMed1981

Sex and surgical stress.

The endocrine and metabolic response to anaesthesia and surgery was studied in 12 men and eight women undergoing elective total hip replacement using buprenorphine as the intra- and postoperative analgesic. Plasma glucose, cortisol and prolactin were measured, and the results obtained for men and women compared. Statistically significant difference between men and women were found for prolactin during and after operation, and also for cortisol postoperatively. Men, but not women, demonstrated a significant fall in plasma cortisol following a dose of buprenorphine after operation. These results are discussed in relation to known procedures for ablating the stress response and to the neuroendocrine effects of opiate agonists and partial agonists.

Aged↗
PubMed1981

Sublingual buprenorphine used postoperatively: clinical observations and preliminary pharmacokinetic analysis.

1 Buprenorphine is a long-acting opiate analgesic. This study was designed to investigate the pharmacokinetics of this drug when given by the sublingual route to ten postoperative patients. Plasma levels of buprenorphine were measured by a specific radioimmunoassay. 2 Plasma levels of the drug following sublingual administration of 0.4 mg showed an apparent delay in absorption and then rose slowly to reach low but significant levels by 3 h. There was considerable variation in the time at which peak levels were achieved. The average systemic availability of the drug by this route was estimated to be 30% by 3 h. 3 Analgesic efficacy and duration of sublingual buprenorphine were assessed using demand analgesia. The analgesia was of about 9 h duration, similar to that achieved by parenteral administration of 0.3 mg of the drug to an equivalent group of patients. The sublingual dose caused a significant fall in the postoperatively elevated group of patients. The sublingual dose caused a significant fall in the postoperatively elevated plasma glucose, and prevented any further rise in plasma cortisol. 4 Reasons for the efficacy of the sublingual route are discussed and it is suggested that this route may be particularly appropriate for highly lipophilic drugs like buprenorphine.

Analgesia↗
PubMed1981

An oral buprenorphine and paracetamol combination compared with paracetamol alone: a single dose double-blind postoperative study.

1 An oral combination of buprenorphine and paracetamol was compared with paracetamol alone in a single dose, double-blind postoperative study. One hundred and twenty patients undergoing elective minor orthopaedic operations were allocated to four groups of 30 patients. The four treatments were 1,1.5 or 2 mg of buprenorphine with paracetamol 1,000 mg or paracetamol 1,000 mg alone. 2 There were no significant differences between the groups in analgesia measured by the observer over the 6 h period of direct observations. The oral opiate produced a significant increase in duration of analgesia beyond the 6 h study period. A significant increase in side-effects was seen only at the highest buprenorphine dose compared with paracetamol. 3 The problems of trial design for analgesic combinations are considered. Drug mixtures create additional complexities which decrease the certainty of the conclusion that no real benefits result from such mixtures.

Acetaminophen↗
PubMed1981

Ammonium and methylammonium transport by the nitrogen-fixing bacterium Azotobacter vinelandii.

Azotobacter vinelandii, grown with NH4+ as nitrogen source, was shown to possess an active transport system which can take up NH4+ against a concentration gradient of 58-fold. The properties of the NH4+ uptake system were investigated with the NH4+ analog CH3NH3+. The use of this analog was justified on the basis of the conclusion that the uptake of NH4+ and CH3NH3 involves a common binding site, as shown by the competitive inhibition of CH3NH3+ uptake by NH4+ (Ki approximately 3 microM). A Lineweaver-Burk plot for CH3NH3+ uptake revealed a biphasic curve, suggesting the existence of two CH3NH3+ (NH4+) uptake systems with apparent Km's for CH3NH3+ equal to 61 microM and 661 microM. The uptake of CH3NH3+ was inhibited by arsenate, as well as by cyanide or carbonyl cyanide-m-chlorophenyl hydrazone, indicating that phosphate bond energy is required.

Arsenates↗
PubMed1981

Unsuspected hypoglycaemia, haemoglobin A1 and diabetic control.

Control of diabetes in a group of 82 insulin-treated diabetics was assessed by in-patient 24-hour plasma glucose profiles and haemoglobin A1 (HbA1) estimation. Thirty-two of these patients (39 per cent) had hypoglycaemia (plasma glucose less than or equal to 2 mmol/l) which was rarely associated with symptoms. Twenty-seven (61 per cent) of 44 patients who took a series of out-patient pre-prandial capillary blood samples over a three-day period had hypoglycaemia. Conventional measurements of diabetic control including fasting plasma glucose and HbA1, were lower in patients with hypoglycaemia than in those without. Rebound hyperglycaemia following hypoglycaemia was not seen and its absence was not due to diabetic autonomic neuropathy. Cortisol/creatinine ratios in early morning urine samples were similar in patients with and without nocturnal hypoglycaemia, consistent with the absence or rebound hyperglycaemia. Diabetic retinopathy was less prevalent in patients with hypoglycaemia, possibly reflecting better long-term diabetic control in this group. HbA1 concentration reflects overall blood glucose control in diabetes but near-normal levels must be interpreted with caution since they may be associated with recurrent hypoglycaemia.

Adult↗
PubMed1981

The pharmacology and clinical pharmacology of indapamide.

At low doses indapamide is a potent and long acting antihypertensive agent in various hypertensive animals and in man, but is without activity in normotensive subjects. A daily dose of 2.5 mg produces a minimal diuresis but at higher doses this increases without any significant augmentation of hypotensive activity. It appears to have no effect on most blood biochemical parameters, including glucose, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, noradrenaline, adrenaline, but potassium levels may decrease and uric acid and renin increase. Indapamide had no effect on renal function nor does it alter left ventricular function, electrocardiograph (ECG) or heart rate, although cardiac output may marginally increase. Total peripheral resistance is significantly decreased and it may exert its antihypertensive effect by reducing vascular reactivity to various pressor stimuli by inhibiting the net inward flow of calcium and resultant phasic contractions in vascular smooth muscle. Indapamide differs from the diuretics in that it has a comparatively high lipid solubility; it is also bound to blood proteins and elastin in vascular smooth muscle and little is eliminated in the urine. It may be for these reasons that the drug has less diuretic activity but more pronounced effect on vascular smooth muscle than compounds of similar structure.

Animals↗