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Biomedical subjects

T H Self

Publications and source records attributed to T H Self.

86 records · Page 5Linked to original sources
PubMed1975

Interaction of rifampin and warfarin.

A 72-year-old man who had been taking rifampin daily for several months was concurrently administered warfarin daily for ten weeks. During this period, the prothrombin time (PT) rose remarkably little as the dosage of warfarin was increased. With difficulty, satisfactory anticoagulation was achieved by giving warfarin 20 mg daily. On discontinuation of rifampin therapy, the PT increased significantly, and subsequent stabilization of the PT within therapeutic range required treatment with warfarin 7.5 mg daily.

Aged↗
PubMedDate not supplied

Clinical and economic outcomes in the hypertension and COPD arms of a multicenter outcomes study.

OBJECTIVE: To evaluate the impact of pharmaceutical care on selected clinical and economic outcomes in patients with hypertension or chronic obstructive pulmonary disease (COPD) in ambulatory care settings. DESIGN: Clinic patients with hypertension or COPD were randomly assigned to a treatment group (pharmaceutical care) or a control group (traditional pharmacy care) over a six-month period. Clinical pharmacists and pharmacy residents conducted the protocols. There were 133 evaluable patients (63 treatment and 70 control) in the hypertension study arm and 98 evaluable patients (43 treatment and 55 control) in the COPD study arm. SETTING: 10 Departments of Veterans Affairs medical centers and 1 academic medical center. INTERVENTIONS: Patient-centered pharmaceutical care model (employing standardized care) implemented by clinical pharmacy residents. MAIN OUTCOME MEASURES: Patient knowledge, medication compliance, and health resource use. RESULTS: The hypertension treatment group had a significantly greater reduction in systolic blood pressure from visit 1 to visit 5 than did the control group. In the COPD study arm, trends were positive in the treatment group for patients ratings of symptom interference with activities and dyspnea measures. There was a significant difference between the hypertension treatment and control group for compliance. There were no significant changes in compliance scores in the COPD study arm. Mean number of hospitalizations and other health care provider visits was higher for the hypertension control group. For patients with COPD, hospitalizations increased in the control group, and the number of other health care provider visits was higher in the control group. CONCLUSION: Pharmacists' participation in a pharmaceutical care program resulted in disease state improvement in ambulatory patients with hypertension and COPD.

Aged↗
PubMedDate not supplied

Nortriptyline absorption in short bowel syndrome.

Severe short bowel syndrome usually requires a period of parenteral nutrition support until gastrointestinal hypertrophy occurs. Because of the shortened length of the gastrointestinal tract, oral drug therapy can be compromised secondary to decreased absorption. In the case presented, a patient with short bowel syndrome who required parenteral nutrition was able to achieve therapeutic nortriptyline serum concentrations while receiving the drug via the oral route.

Administration, Oral↗
PubMedDate not supplied

Noneffect of methyldopa on urine glucose tests.

Methyldopa has been reported to cause a false-positive urine glucose test by the copper reduction method (Clinitest). We investigated the effect of methyldopa on urine glucose tests in 30 patients by comparing commonly used glucose oxidase methods to Clinitest. The results of our study indicate that methyldopa does not interfere with the copper reduction method for urine glucose determination.

Copper↗
PubMedDate not supplied

Noneffect of isoniazid on urine glucose tests.

Isoniazid has been shown by in vitro study to reduce Clinitest tablets. The effect of isoniazid on urine glucose tests was investigated in 30 patients by comparing commonly used glucose oxidase methods to Clinitest. Study results indicate that isoniazid does not cause clinically significant interference with the copper reduction method for urine glucose determination.

Adult↗
PubMedDate not supplied

Reassessment of the role of theophylline in the current therapy for nocturnal asthma.

BACKGROUND: Symptoms of asthma commonly increase at night for a variety of reasons. While different options are available for the management of nocturnal asthma, theophylline has maintained a prominent role in treating this problem, and it is widely promoted as a first-line agent. Very recent reports stress the use of anti-inflammatory agents as the drugs of choice for the long-term treatment of asthma. METHODS: Using the key words "asthma," "theophylline," "bronchodilators," "adrenal cortex hormones," "beclomethasone," "triamcinolone acetonide," and "disodium cromoglycate," the MEDLINE files were searched from 1982 to the present. Articles dating before 1982 were accessed from cross-reference of the more recent articles. RESULTS: Sustained-release theophylline preparations are effective in decreasing the rate of exacerbations of nocturnal asthma symptoms, but theophylline has risks of major toxicity and serum concentrations must be monitored. Inhaled corticosteroids are also useful in controlling nocturnal asthma, and they reduce inflammation, which is the basic problem in asthmatics. Inhaled anticholinergics and oral controlled-release albuterol are also helpful in reducing symptoms of nocturnal asthma. CONCLUSIONS: A suggested approach to managing nocturnal asthma includes corticosteroids inhaled through a spacer device at optimum doses, adding inhaled albuterol or oral sustained-release albuterol and then ipratropium with a spacer. If control is not maintained with this regimen, sustained-release theophylline may add benefit to inhaled steroid therapy in reducing nighttime asthma symptoms. Long-acting inhaled beta 2 agonists show promise and could be the adjunctive treatment of choice when they become available in the United States.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Reassessing the therapeutic range for theophylline on laboratory report forms: the importance of 5-15 micrograms/ml.

The therapeutic status of theophylline has changed dramatically over the last decade. As part of this change, a different view of the most appropriate therapeutic range for serum theophylline concentration (STC) has emerged. The National Institutes of Health Expert Panel Report, "Guidelines for the Diagnosis and Management of Asthma," suggests a conservative approach of aiming for STC of 5-15 micrograms/ml. This truly landmark document along with several studies in the literature, recently prompted us to change our hospital's laboratory report form for the medical record to read that the therapeutic range for STC is 5-15 micrograms/ml. We encourage hospital laboratories or other clinical laboratories who have not already made this change to do so.

Asthma↗