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Biomedical subjects

R A Prince

Publications and source records attributed to R A Prince.

49 records · Page 3Linked to original sources
PubMed1977

Agranulocytosis associated with procainamide therapy--report of a case.

The case of a 69-year-old woman with procainamide-induced agranulocytosis is reported, and literature reports of 14 other such cases are reviewed. The patients was exposed to procainamide, prescribed for atrial fibrillation, for 26 days, with a daily dose of 1.5 to 4 g and a total dose of 57.5 g. She recovered from agranulocytosis after discontinuation of the drug and hospital treatment for 16 days. Among the reported cases of procainamide-induced agranulocytosis, the daily dosage ranged from 750 mg to 4.5 g; the total ingested dose before agranulocytosis was observed ranged from 36.5 to 316.3 g. Patients treated with procainamide should be instructed to report any soreness of the mouth, throat or gums; unexplained fever; or any symptoms of upper respiratory tract infection. If white blood cell counts indicate bone marrow depression, the drug should be withdrawn and appropriate evaluation begun at once.

Aged↗
PubMed1977

Nitrofurantoin polyneuropathy: report of two cases.

Two case reports of patients who developed a toxic neuropathy associated with nitrofurantoin are presented. In each case the patient had normal renal function and the symptoms abated upon withdrawal of the drug. Although the specific mechanism by which nitrofurantoin causes the neuropathy is still not known, various hypotheses are discussed and the literature is reviewed. The danger of nitrofurantoin administration in patients with impaired renal function is emphasized, and it is stress that early signs and symptoms of peripheral neuropathy be reported and the drug immediately discontinued. Even in the presence of normal renal function, the recommended dosage and duration of therapy should not be exceeded.

Administration, Oral↗
PubMedDate not supplied

Influence of bariatric surgery on erythromycin absorption.

Seven adult, morbidly obese patients scheduled for bariatric surgery were studied in an identical manner preoperatively and postoperatively. Six patients underwent gastroplasties, and one patient underwent a gastric bypass procedure. A single 250-mg dose of erythromycin as a Filmtab was administered orally after an overnight fast. Multiple venous blood samples were collected over a 12-hour period. After surgery, each patient had a decrease in peak concentration and an increase in the time to reach peak concentration compared to presurgery values. Mean peak concentration was reduced from 1.04 micrograms/ml preoperatively to 0.55 micrograms/ml postoperatively, and the mean time to peak increased from 3.9 hours to 6.7 hours. Mean weight-corrected AUC was reduced 41 per cent, with two patients having no detectable serum levels postoperatively. The results suggest that the erythromycin product evaluated is of questionable value for use in bariatric surgery patients.

Adult↗
PubMedDate not supplied

Mechanism of action, antimicrobial activity, pharmacology, adverse effects, and clinical efficacy of cefotaxime.

Cefotaxime sodium, a parenteral cephalosporin antibiotic, exerts its bactericidal action through inhibition of bacterial cell wall synthesis. Chemical structure modifications have enabled this compound to be resistant to the action of Richmond I, III, IV, and V beta-lactamase enzymes. Excellent activity against many gram-negative bacilli, especially Enterobacteriaceae, has been demonstrated. Antipseudomonal activity is generally poor, however. Activity against gram-positive cocci, with the notable exception of Streptococcus fecalis, is adequate. Anaerobic activity is variable, particularly against Clostridia and Bacteroides species. Acute, subacute, and chronic toxicity studies in animals were generally unremarkable. No mutagenic effects or reproductive toxicity have been noted in animals. In man, cefotaxime is desacetylated to a microbiologically active metabolite. Urinary excretion is approximately 50-60% and 15-20% of a dose for the parent compound and desacetyl metabolite, respectively. The elimination half-life of cefotaxime is about one hour, with the total body clearance being approximately twice that of the renal clearance. Severe renal dysfunction causes a prolongation of the elimination half-life of cefotaxime and particularly desacetyl cefotaxime. A relatively low degree of protein binding in part attributes to a wide bodily distribution of cefotaxime. Cefotaxime is effective in a variety of infectious processes caused by susceptible organisms. Local reactions at the injection site and hypersensitivity phenomena are the most common adverse effects. Comparative trials attesting to cefotaxime's clinical utility over other parenteral cephalosporins or amino-glycosides are very limited. Based on the available evidence, cefotaxime should be most useful in combating serious gram-negative infections, because of its excellent activity against most of these organisms and its low toxicity profile.

Adult↗
PubMedDate not supplied

Antimicrobial update.

New and soon-to-be introduced antimicrobials are reviewed and compared with agents already in use to determine possible therapeutic and/or cost advantages. Drugs discussed are amdinocillin, ticarcillin/clavulanic acid, ceftriaxone, ceftazidime, imipenem/cilastatin, aztreonam, and quinolones.

Amdinocillin↗
PubMedDate not supplied

Effect of tetracycline hydrochloride on theophylline kinetics.

The effect of tetracycline hydrochloride on theophylline kinetics was studied. Eight nonsmoking men received a 15-minute infusion of theophylline (aminophylline) 5 mg/kg before (control) and after (experimental) a seven-day tetracycline course of 1 g daily. Each subject acted as his own control. Multiple serum samples were collected for 24 hours after each dose and were analyzed for theophylline by enzyme immunoassay. At each phase of study the mean +/- S.D. pharmacokinetic values were as follows: apparent volume of distribution (liter/kg), 0.44 +/- 0.05 (control) and 0.42 +/- 0.04 (experimental); clearance (ml . min/kg) 0.82 +/- 0.15 (control) and 0.73 +/- 0.07, (experimental); and elimination half-life (hours), 6.27 +/- 1.08 (control) and 6.72 +/- 0.78 (experimental). Tetracycline did not significantly alter the kinetics of theophylline. The probability of missing a 25% change in the kinetic values (Type II error) was less than 6%. Patients receiving theophylline do not appear to be at added risk for the development of toxicity as a result of a kinetic interaction when tetracycline hydrochloride is added to the therapeutic regimen.

Adult↗