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Biomedical subjects

R B Stewart

Publications and source records attributed to R B Stewart.

At least 163 records · Page 9Linked to original sources
PubMed1981

Selected physiologic and drug effects on serum uric acid levels in an elderly population.

A total of 2,923 elderly subjects were studied to determine the relationship between obesity, hypertension, thyroid disease, renal function, alcohol consumption, selected drugs, and the serum uric acid level. Comparison of the serum uric acid levels with indices of obesity demonstrated a strong correlation in normotensive (p less than .0001) and hypertensive (p less than .001) subjects. The serum creatinine level, when used alone, was not a reliable indicator of renal function. Of the drugs evaluated, diuretics had the most pronounced effect upon the serum uric acid level.

Aged↗
PubMed1981

Practicality of a lithium dosing guide.

A method of dosing lithium based on a 24-hour serum lithium level obtained after a single 600-mg oral dose of lithium carbonate has been reported to provide a steady-state lithium concentration of 0.6--1.2 mEq/liter. Since this regimen is widely used in clinical practice, the authors designed a study to determine the practicality of the dosing guide. Of 13 patients who followed this dosing protocol, 4 (30.7%) failed to achieve the defined steady-state range. The authors discuss factors that may affect the reliability of the dosing guide.

Administration, Oral↗
PubMed1981

Clinical utility of six methods of predicting phenytoin doses and plasma concentrations.

The usefulness of six reported methods of predicting phenytoin doses or plasma concentrations in epileptic patients is compared. Forty adult epileptic outpatients who were taking phenytoin sodium orally were followed prospectively for nine months; 16 met requirements for inclusion in the study. Six methods of predicting phenytoin dosage or plasma concentrations--one equation, two nomograms, and three graphs--were compared to actual phenytoin doses and corresponding steady-state serum levels. Criteria establishing good, high, and low predictions were specified for each method. No method produced consistently accurate results. Good dosage predictions occurred in 42-60% of the predictions with the six methods. Low predictions occurred in 0-50% of the estimates; 8-53% of the predictions were high. It is concluded that certain methods are clinically useful under some conditions if recommended cautions are observed.

Adult↗
PubMed1980

The relationship between adenosine 3':5'-cyclic monophosphate (cAMP) and interferon activity in mouse cells.

Three mouse cell lines (L, 3T3, and SV 3T3) were studied with respect to the elevation of cellular cAMP levels following interferon treatment, and the effect of stimulators of cAMP levels on the antiviral activity of interferon. Interferon treatment resulted in increased cAMP levels in L and 3T3 cells but not in SV 3T3. The antiviral activity of interferon in cells treated with epinephrine and 1-methyl-3-isobutyl xanthine (stimulators of cAMP levels was potentiated in L cells, but not in 3T3 cells and was lost in SV 3T3 cells.

1-Methyl-3-isobutylxanthine↗
PubMed1980

The Dunedin program, a Florida geriatric screening process: design and initial data.

The Dunedin program was started in 1975 for the purpose of screening participants over the age of 65, for medical disorders. Data are collected on family history, past medical history, drug history, current symptoms and disorders, and numerous biochemical and physiologic factors. In the past four years, 4,363 participants have been evaluated and a large data base has been derived concerning the 65+ age group. It is hoped that data from this program will facilitate the future assessment, treatment and care of the elderly.

Aged↗
PubMed1980

Drug-related admissions to an inpatient psychiatric unit.

The authors prospectively monitored 60 consecutive admissions to an inpatient psychiatry service to determine the role of drugs in psychiatric hospitalization. They categorized drug-related problems as 1) drug intoxication, 2) drug abuse, 3) side effects of therapeutic drugs, and 4) noncompliance with prescribed medications. During the 6-month study 25 (41.7%) of the admissions were related to drug use; in 16 (26.7%) admissions a drug-related problem was identified as the primary cause of hospitalization. Alcohol was involved in 8 admissions, and Fiorinal, cocaine, and flurazepam were each related to 2 admissions.

Adult↗
PubMed1980

Lithium carbonate and leukocytosis.

White blood cell (WBC) counts of 37 hospitalized adult psychiatric patients were examined for changes during treatment with lithium carbonate. Group 1 (n = 19) patients had WBC counts taken before and after lithium therapy. Group 2 (n = 16) patients had WBC counts taken only after lithium therapy. The remaining two patients had infections and were considered separately. In Group 1, a significant leukocytosis was observed over baseline values (p less than 0.001). The mean increase in WBC count was 2,237 cells/cu mm. For Group 2 patients, the mean WBC count observed was 11,950 +/- 4,028 cells/cu mm, which is higher than the normal leukocyte count in peripheral blood. An increase in circulating leukocytes was observed in the majority of these patients. The data indicate that the leukocytosis was drug related, but the increase did not appear to be dose related or dependent on the concentration of lithium in the blood.

Adult↗
PubMed1980

Doxepin-induced acute glossitis.

A case of doxepin-induced acute glossitis is reported. Painful, tender, papular lesions on the tongue were observed in a 48-year-old woman seven days after initiation of doxepin and ampicillin therapy. Doxepin daily dosage (administered in four divided doses) subsequently was reduced from 175 to 150 to 125 mg, then both drugs were discontinued. The glossitis, treated with viscous lidocaine, resolved over a three-week period. Four weeks after doxepin therapy was firt initiated, the drug was reinstituted; glossitis recurred eight days later. After discontinuation of doxepin, the glossitis slowly regressed. Drug-induced glossitis, its mechanism of action, and treatment are reviewed. When unexpected oral inflammation and pain occur, the potential for drug-induced oral lesions should be considered. Treatment is primarily empirical, with unresponsive cases being candidates for therapy of corticosteroids applied topically to the oral lesions.

Acute Disease↗
PubMed1980

Carbamazepine-induced leukocytosis.

An apparent case of carbamazepine-induced leukocytosis in a 26-year-old woman is presented. When admitted for psychiatric evaluation, the patient had been receiving carbamazepine for seizures for some time. A hemogram revealed a white blood cell (WBC) count of 21.2 x 10(3)/cu mm. Five days after the patient's medication was changed from carbamazepine (600 mg/day) to phenytoin (400 mg/day) and phenobarbital (120 mg/day), her WBC count was within normal range. When she experienced dizziness and ataxia, the phenytoin and phenobarbital were replaced with carbamazepine (600 mg/day). WBC counts performed 11 and 13 days after resumption of carbamazepine therapy again were significantly elevated. Other drugs administered during hospitalization included chlorpromazine, acetaminophen, and codeine. The possible causes of and pathophysiology of leukocytosis are reviewed. The changes in WBC that occurred with the rechallenge of carbamazepine indicate that the drug was the probable cause of the leukocytosis.

Adult↗
PubMed1979

Epidemiology of hyperuricemia in an ambulatory elderly population.

The relationship of serum uric acid concentration to age and sex was assessed in 1,701 participants in a geriatric multiphasic screening clinic. Included were 1,067 women and 634 men. The mean uric acid level for men was 6.35 mg/100 ml compared to 5.44 mg/100 ml for women. No statistically significant increases in serum uric acid between age groups were apparent, except for women over 84 years of age. The mean serum urate concentrations found in this geriatric study are higher than those reported for other population groups, suggesting a higher normal value for the elderly.

Age Factors↗
PubMed1979

Drug use in a geriatric population.

Drug usage was studied in a geriatric hypertension-screening program. A questionnaire was used to collect the required information from patients visiting the clinic during three successive years. The study included 1,711 patients, of whom 76.6 percent were regularly using a drug preparation. A consistent increase was noted in the average number of drug categories used with increasing age, from 1.6 in patients under 70 to 2.6 in patients over 84 years old. The most common drug categories involved were antihypertensive agents, cardiovascular drugs, vitamins, and internal analgesics.

Aged↗
PubMed1979

Nonpharmacy outlets providing prescription medications to ambulatory patients.

Nonpharmacy outlets providing prescription medication to ambulatory patients in Alachua County, Florida, were investigated. The sample included 16 ambulatory clinics and 44 dispensing physicians. The types of medications dispensed and dispensing procedures used by these outlets are described. The magnitude of prescription drug dispensing in ambulatory clinics and physicians' offices was far greater than was initially expected. Numerous drug-related problems were identified within these outlets, including a failure to comply with state and federal laws, inadequate drug control and storage, and inadequate patient medication records. Practicing pharmacists should consider the possibility of their patients receiving medication from similar outlets in evaluating therapies for appropriateness and interactions. In addition, such centers have apparent need for pharmacy consultation services to ensure adherence to the principles of responsible pharmaceutical services.

Adult↗
PubMed1979

Efficacy of antiparkinson agents in preventing antipsychotic-induced extrapyramidal symptoms.

The types of extrapyramidal syndrome (EPS) reactions produced by antipsychotic agents and the prophylactic use of antiparkinson agents in preventing EPS are reviewed. EPS are classified as akathisias, dystonias, parkinson-like symptoms and tardive dyskinesia, and have a varied incidence reported to range from 10.6 to 100%. Incidence may vary with age, gender, drug and dosage. The prophylactic use of antiparkinson agents to prevent EPS is controversial. Many psychiatrists believe the effect of EPS on patients is more harmful than the side effects of anticholinergics, whereas others believe that because of side effects, increased cost, greater risk to tardive dyskinesia and improper use, the use of antiparkinson agents cannot be justified. Most studies of prophylactic use of antiparkinson agents have lacked adequate control groups, adequate blinding procedures for investigators rating EPS, uniform definitions of EPS, random sampling and careful reporting of group characteristics such as dosage and drugs received. There is a lack of definitive studies of the value of antiparkinson agents in preventing the occurrence of EPS in patients receiving antipsychotics. A large, multicenter study should be undertaken to resolve the issue.

Antiparkinson Agents↗