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Biomedical subjects

R W Sloan

Publications and source records attributed to R W Sloan.

12 recordsLinked to original sources
PubMed1992

Principles of drug therapy in geriatric patients.

The elderly comprise 12 percent of the U.S. population but consume 33 percent of all prescription drugs. The incidence of adverse drug reactions is significantly higher in persons over age 65 than in younger population groups. The increased risk of adverse drug effects is related to decreased organ reserve capacity, to altered pharmacokinetics and pharmacodynamics, and to polypharmacy with associated drug-drug and drug-disease interactions. An organized therapeutic plan and critical evaluation of the list of drugs an elderly patient is taking will help in establishing a safe and effective drug regimen.

Age Factors↗
PubMed1989

Alternative first-line therapies in geriatric hypertension.

Between 45 and 60% of elderly persons have mild to moderate hypertension. In those with combined systolic/diastolic hypertension, blood pressure reduction significantly reduces morbidity and mortality. Secondary causes of hypertension, particularly renovascular, should be considered in elderly patients with a recent history of hypertension. Because of their proven efficacy and low cost, low-dose thiazide diuretics remain an important first-line therapy. Angiotensin-converting enzyme (ACE) inhibitors and calcium-channel blocking agents have also been shown to be effective and well-tolerated in the elderly. Increased attention is being paid to adverse drug effects and to the overall effect of antihypertensive therapy on quality of life. ACE inhibitors are particularly attractive in the elderly due to their possibilities in this area. In the elderly, the combination of a low-dose thiazide diuretic with an ACE inhibitor enhances antihypertensive efficacy while blunting the adverse metabolic effects of the diuretic.

Aged↗
PubMed1986

Atrial fibrillation.

Explore the source record for details and available documents.

Anti-Arrhythmia Agents↗
PubMed1983

Digitalis glycosides.

The digitalis glycosides are potent cardiovascular drugs with a low therapeutic index and a high incidence of iatrogenic complications. Digoxin is the most commonly used preparation. Common indications include rate control in atrial fibrillation, as well as the treatment of other atrial tachyarrhythmias, and low-output congestive heart failure. Digitalis is contraindicated in idiopathic hypertrophic subaortic stenosis (unless atrial fibrillation is present) and in some patients with Wolff-Parkinson-White syndrome.

Arrhythmias, Cardiac↗
PubMed1983

Hyperlipidemia.

Ten percent of the U.S. population has hyperlipidemia. The most commonly encountered phenotypes include Type IIa, Type IIb and Type IV. Anion-exchange resins are the drugs of choice for hypercholesterolemia, while gemfibrozil is the preferred agent for massive hypertriglyceridemia. Clofibrate is the drug of choice for the rare Type III hyperlipidemia. Successful management begins with evaluation of the total clinical picture, including genetic factors, measurement of cholesterol and triglycerides, and visual examination of the serum.

Chylomicrons↗
PubMed1983

Drug interactions.

Drug interactions have been implicated in approximately 7 percent of all reported adverse drug reactions. Although many drug interactions are not clinically significant, the potential for an interaction increases from 5.6 percent in patients receiving two drugs to 100 percent in patients receiving eight or more drugs. Drug interactions can involve alterations in the pharmacokinetic parameters of absorption, distribution, metabolism and excretion, or can result from cumulative or antagonistic effects.

Adolescent↗
PubMed1983

The effect of chlorpropamide hyponatremia on mental status in a nursing home population.

Fifty-nine nursing home patients (average age, 79.9 +/- .9 years) receiving chlorpropamide were screened with a serum sodium determination. Nine patients (15.3 percent) had a serum sodium concentration less than 135 mEq/L; six of these patients (10.2 percent) had a serum sodium equal to or less than 130 mEq/L; none of the patients had a serum sodium less than 125 mEq/L. Five hyponatremic patients (Na less than or equal to 130 mEq/L) and nine normonatremic patients (Na greater than or equal to 135 mEq/L) were screened with a standardized mental status examination and additional laboratory studies. The hyponatremic patients were switched to tolazamide after a one-week wash-out period, and the mental status examination and laboratory studies were repeated in both groups four weeks later. One patient in the hyponatremic group died during the course of the study; the other four became normonatremic on tolazamide. Mental status scores increased significantly in the hyponatremic group, 16.0 +/- 3.6 to 20 +/- 4.6 (a 37.3 +/- 21.5 percent increase), compared with the normonatremic group, 14.5 +/- 2.6 to 15.8 +/- 2.9 (a 7.8 +/- 3.2 percent increase). There were no significant differences in serum glucose, creatinine, chlorpropamide, or antidiuretic hormone concentrations between the two groups. It is recommended that periodic serum sodium determinations be obtained in geriatric patients receiving chlorpropamide.

Aged↗
PubMed1982

Atrial fibrillation.

Although most cases of sustained atrial fibrillation are associated with mitral valve disease, hypertension, cardiac failure and atherosclerotic heart disease, some cases occur in the absence of any identifiable organic pathology. The consequences of atrial fibrillation include reduction in cardiac output, systemic emboli and an exaggerated ventricular response to exercise. In most clinical situations, digoxin is the drug of choice for controlling the ventricular response. Cardioversion should be undertaken in appropriately selected patients.

Age Factors↗