Biomedical subjects
Publications and source records attributed to T H Self.
In a patient who had been receiving digitoxin therapy, the serum digitoxin level decreased markedly when rifampin was added to the therapeutic regimen. The serum digitoxin level returned to the pretreatment level when rifampin therapy was discontinued.
The pharmacokinetic disposition of theophylline after a single 10mg/kg intravenous dose of aminophylline was evaluated in six rabbits. Three then received rifampin (50mg/kg) a day for 14 days and the disposition of theophylline was re-evaluated in all six rabbits after another 10mg/kg aminophylline dose. The mean theophylline half life before rifampin treatment of 5.11 +/- 0.71 hrs was not different (p greater than 0.10) from the half life of 4.54 +/- 0.71 hrs after treatment with rifampin. In the non-rifampin treated rabbits, the initial mean theophylline half life of 4.78 +/- 1.05 was not different p greater than 0.80) from the half life of 4.94 +/- 1.92 hrs after fourteen days. No significant alterations in clearance or area under the curve were noted for either group. Power analysis indicated that three rabbits were sufficient to detect at least a 25% change in the parameters as being significant (p less than 0.05).
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A study was conducted to: (1) evaluate the effect of a slide-tape program on patients' short-term and long-term knowledge about their bronchodilator medications; and (2) determine it any differences exist in learning or retention patterns for different content areas of drug information. The knowledge of 30 patients was measured using a randomized sequence of three comparable 15-question tests. The first test was given before the slide-tape program was presented, the second test within 24 hours, and the last test one to six months (mean = 2.8 months) later. Scores attained on the first posttest were significantly higher (p less than 0.001) than pretest scores. Learning differences among drug-information-content areas were not evidenced on the first posttest. No significant difference was demonstrated between scores on pretest and last posttest (p = 0.100). However, retention patterns among content areas were found to differ significantly (p less than 0.05). Carefully designed audiovisual programs can impart drug information to patients. Medication counseling should be repeated at appropriate opportunities because patients lose drug knowledge over time.
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A 62-year-old man who had been taking 250 mg of chlorpropamide daily for several years received rifampin concomitantly and had a subsequent increased dosing requirement of chlorpropamide. When rifampin was discontinued several months later, the serum chlorpropamide concentration rose dramatically.
Staffing a majority of hospitals with full-time clinical pharmacists is an aim that will not be attainable for many years. In an effort to demonstrate an interim approach to clinical practice that could be applied to a large percentage of hospitals, a part-time clinical pharmacist's services were documented. Serving a teaching hospital with an average census of 97 patients, the pharmacist, with a 50 percent time allotment for clinical services, monitored 229 total admissions during an eleven week period. The majority of patients were on either a pulmonary medicine or urology service. The total number of actions taken as a result of pharmacy consultations was 106, with 70 percent of these being related to dosing problems. It was concluded that a pharmacist providing clinical services to a large patient population on a less than full-time basis can have a positive impact on drug therapy.
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Taste preferences among three oral liquid theophylline preparations were evaluated in 54 males. The products tested, and their theophylline concentrations, were Elixophyllin Pediatric Suspension (Cooper Laboratories, Inc.), 100 mg/5 ml; Somophyllin Oral Liquid (Fisons Corporation), 90 mg/5 ml; and Theophyl-225 Elixir (Knoll Pharmaceutical Company), 37.5 mg/5 ml. Generally-recommended procedures for taste tests were followed. The results indicated a taste preference for Theophyl-225 Elixir, followed by Elixophyllin Pediatric Suspension, followed by Somophyllin Oral Liquid. The results were statistically significant (p = 0.05). Product concentration and formulation were suggested to be major factors in determining taste preference.
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Clinical observations and studies regarding hyperthyroidism and enhanced response to warfarin are reviewed. The reported cases of increased sensitivity to warfarin in hyperthyroidism are summarized, and possible mechanisms for this disease-drug interaction are discussed. Most recent studies indicate that the activity of warfarin is enhanced in hyperthyroidism because of increased catabolism of vitamin-K-dependent clotting factors.
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