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Biomedical subjects

W W Buchanan

Publications and source records attributed to W W Buchanan.

At least 127 records · Page 7Linked to original sources
PubMed1987

The pharmacokinetics of isoxicam in elderly patients with rheumatoid arthritis.

Nineteen patients, aged 60 years and over, with rheumatoid arthritis participated in a clinical trial to investigate the pharmacokinetics of isoxicam (a new non-steroidal anti-inflammatory drug) in this age group. The purpose of the study was to determine if the pharmacokinetics are different compared to a younger healthy population. The half-lives were independent of dosage, indicating linearity of pharmacokinetics. Furthermore, the half-lives after repeated dosing were not different from those found after single doses of 400 mg. This shows that there is neither undue accumulation of the drug nor induction of its own metabolism. These results are similar to the results obtained in other centres when isoxicam was administered to healthy subjects between 18 and 32 years.

Aged↗
PubMed1987

Variation in physical and biological properties of solid gold sodium thiomalate on dissolution: an electron microscopic and energy dispersive spectroscopic study.

The dissolution of solid gold sodium thiomalate (GSTM) in water results in loss of yellow color. We studied the initial reaction on dissolution. It was associated with the disappearance of 2 absorption peaks on ultraviolet spectrum, one a well defined peak at 335 nm and the other a shoulder at 370 nm. This solution caused platelet aggregation and on transmission electron microscopy, dense gold containing particles measuring 125 nm are seen. Within 10 min of onset of dissolution, no gold containing particulate matter was detectable on electron microscopy. By 20 min, fibrillar particles measuring 40-150 nm appear. These resembled in general morphology and element composition the particles seen within aurosomes in platelets treated with Myochrysine (GSTM) and in synovium and other tissues by other workers. Our data elaborate on previous physical and chemical studies and correlate with morphological variations of gold containing particles at different phases. These variations in GSTM may be due to polymer size and/or structural change within the polymer. The biochemical significance of our data should provide better understanding of the biological effects of these gold thiol compounds in vivo.

Blood Platelets↗
PubMed1987

Low dose cyclosporine in rheumatoid arthritis: a pilot study.

A 6 month open trial of cyclosporine (CyA) was conducted in 20 patients with active rheumatoid arthritis unresponsive to second line therapy. The dosage was monitored to achieve a serum blood level of 75-150 ng/ml. A 25% reduction in ARA joint count (baseline mean 38.2; 6 month or time of CyA withdrawal mean 28.7; p less than 0.001) was observed for all patients. Fifteen completed the 6 month CyA regimen and 5 developed toxicity requiring CyA to be permanently withdrawn. For the 15 patients completing 6 months of CyA, improvement was 36% (baseline 34.7; 6 month mean 22.2; p less than 0.001). Corresponding improvements were also observed on the other main study outcomes of pain and functional ability. Improvement occurred between 12-20 weeks, somewhat later than in other studies. Toxicity included mild hypertension (4 patients) and gastrointestinal intolerance (2). Three patients were withdrawn from CyA due to nephrotoxicity. There was a clinically significant reduction in calculated creatinine clearance but this returned to baseline within 6 months after CyA was withdrawn for all except 2 patients who took 12 months to return to baseline.

Adult↗
PubMed1986

European experience with flurbiprofen. A new analgesic/anti-inflammatory agent.

Numerous European clinical trials begun more than 12 years ago have clearly demonstrated flurbiprofen's safety and efficacy as an analgesic, anti-inflammatory, and antipyretic agent. In preclinical studies, flurbiprofen was at least as potent as indomethacin, and approximately 200 times more potent than aspirin. For patients with rheumatoid arthritis, a review of several trials found flurbiprofen often superior to aspirin and naproxen, and equivalent to indomethacin and ibuprofen in efficacy. Acetaminophen appeared no more effective than placebo for patients with rheumatoid arthritis. For patients with ankylosing spondylitis, flurbiprofen was also shown to be equivalent or superior to indomethacin and phenylbutazone. For patients with osteoarthritis of the peripheral joints, spine, hip, and knee, flurbiprofen was again found equal to ibuprofen, diclofenac, indomethacin, and naproxen. Side effects with flurbiprofen were few and predominantly related to the gastrointestinal tract.

Aspirin↗
PubMed1986

A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee.

Current methods of clinical assessment in osteoarthritis show a high degree of variability. By contrast, patients with rheumatoid arthritis may be evaluated using a number of standardised and validated indices. One hundred patients with primary osteoarthritis of the hip and knee were interviewed in order to determine the dimensionality of their discomfort and disability and to define the clinical importance of each component item. The symptomatology of osteoarthritis was captured by five pain, one stiffness, twenty-two physical, eight social and eleven emotional items. In spite of a high degree of variability in the frequency of involvement of the individual items, their clinical importance was similar both within as well as across dimensions. Further studies are indicated to determine the reliability, validity and responsiveness of each of the items identified as a prelude to developing a standardized method of assessing patients with osteoarthritis of the hip and knee.

Activities of Daily Living↗
PubMed1986

Diagnosis of rheumatic disease: a plea for contemplation of the future.

In clinical practice the definition of diagnosis is far from clear, since different levels of diagnosis are employed from the symptomatic to the pathological and aetiological. The recent development of computer data bases has important implications for the future, but will require a great deal of thought regarding the nature and quality of the data to be used. Evolution of diagnosis has occurred gradually during the history of medicine. As we see it, computer-assisted data handling will have a profound effect on diagnosis and classification of disease. To meet this challenge we require to define our terms regarding diagnosis of rheumatic disorders. In this paper we comment on the state of the art of diagnosis and classification of rheumatic diseases, and then propose changes to meet the needs of future developments.

Arthritis, Rheumatoid↗
PubMed1986

Double-blind randomized controlled trial of isoxicam vs piroxicam in elderly patients with osteoarthritis of the hip and knee.

1 Fifty-seven elderly patients with primary osteoarthritis of the hip and knee were entered into a double-blind, randomized, controlled parallel group trail to compare the efficacy and tolerability of isoxicam (maximum = 200 mg day-1) and piroxicam (maximum = 20 mg day-1). 2 Clinical assessments were made following a 1 week NSAID-free washout period and at biweekly intervals during the next 6 weeks of active treatment. 3 The majority of patients in both groups experienced a clinically important and statistically significant therapeutic response. 4 No statistically significant between-group differences were noted with respect to drug efficacy. 5 One patient was withdrawn from the piroxicam group because of lack of effect, but there were no such withdrawals from the isoxicam group. 6 Five patients were withdrawn from the piroxicam group because of adverse reactions compared to only one withdrawal from the isoxicam group. 7 This study indicates that isoxicam is an efficacious and well-tolerated once-daily NSAID for elderly patients with osteoarthritis.

Aged↗
PubMed1986

Lowering of plasma isoxicam concentrations with acetylsalicylic acid.

The pharmacokinetics of isoxicam 200 mg administered orally in 10 healthy male volunteers was studied before and during administration of acetylsalicylic acid 3.9 g daily by mouth starting 5 days after isoxicam. There was a statistically significant decrease in plasma isoxicam concentrations, but no significant change in time to reach maximum plasma concentration or disappearance time. The mechanisms of this interaction is probably competitive displacement of isoxicam from albumin by acetylsalicylic acid or salicylate. These results are consistent with the known effect of ASA in producing competitive displacement of other protein bound antiinflammatory drugs.

Administration, Oral↗
PubMed1985

Pharmacokinetics of isoxicam in the elderly.

Several studies are under way to determine the pharmacokinetics of isoxicam in the elderly; this report presents preliminary results of these studies. Data have been collected from: eight healthy subjects older than 65 years old receiving single oral doses of 200 mg; eight patients with rheumatoid arthritis, 61 to 69 years old, receiving oral doses of 400 mg per day; and the same eight patients with arthritis receiving 100 mg per day (four patients), 200 mg per day (one patient), or 300 mg per day (three patients). The plasma levels of isoxicam were determined in the subjects for 96 hours following administration. The results indicate that the mean half-life of isoxicam is approximately 24 hours and is independent of dosage. The results were compared with those in 30 healthy subjects aged 18 to 32 years. The comparison showed that the half-life of isoxicam appears to be independent of dosage, duration of treatment, and age of subject. On the basis of these preliminary results, it appears that elderly patients are not at risk of excessive accumulation of isoxicam during treatment with therapeutic dosages.

Absorption↗