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PubMed1985

[A survey on the current status and trends in bladder irrigation].

Questionnaires were sent to pharmacies and clinics in 592 Japanese hospitals from July to November, 1983 to investigate the use of bladder irrigation. The questionnaires were completed and returned by 418 hospitals, the rate of response being 70.8%. Fifty eight kinds of irrigants were prepared in hospital pharmacies and were reported to have been used in 1,171 patients. Of these irrigants, chlorhexidine gluconate accounted for 18.8%, Polymyxin B for 17.1%, normal saline for 13.3%, potassium permanganate for 6.9%, and boric acid for 5.7%. Chlorhexidine gluconate was usually used at a concentration of 0.02% (in 79% of the total use of the agent), Polymyxin B at 0.01%, 0.02% and 0.05%, potassium permanganate at 0.01% and 0.02% (in 73% of the total use), and acrinol at 0.01%, 0.05% and 0.1%. To questions about side effects, such as irritation, 65 hospitals answered that irritation had occurred. Irrigants were most frequently supplied to non-disposable 500 ml containers used exclusively for this purpose, 38% of all the hospitals using this method. Non-disposable 1 liter containers for exclusive use with bladder irrigants were used in 23% of the hospitals. Purified water was most frequently used to prepare the bladder irrigants (in 35% of hospitals) followed in descending order, by sterile purified water in 33%, and distilled water for injection in 26%. Water for irrigants was prepared at the hospital in 83% of the hospitals. The time of storage of the prepared bladder irrigants was mostly one week to one month, and was within one month in 78% of the hospitals. Seventeen percent of the hospitals answered that the preparation of bladder irrigants was a cause of overwork in their pharmacies. Irrigants against Pseudomonas infections were prepared separately in 40% of the hospitals, and there was no such regulation in 37%. Forty four agents were used to prepare such irrigants, and Polymyxin B accounted for 50%. The use of these agents significantly (P less than 0.001) differed between hospitals. Forty eight percent of the hospitals made special preparations for patients with clouded urine, and there was no such regulation in 46%. Thirty nine agents were used for this purpose. Polymyxin B was used in 30%, and chlorhexidine gluconate in 19%. The use of these agents differed significantly (P less than 0.001) between hospitals.(ABSTRACT TRUNCATED AT 400 WORDS)

Disinfection↗

PubMed1981

Proton gradients in renal cortex brush-border membrane vesicles. Demonstration of a rheogenic proton flux with acridine orange.

The fluorescence quenching of acridine orange has been used to study the formation and dissipation of acid interior pH gradients in brush-border membrane vesicles from rabbit renal cortex. Acidic interior pH gradients were produced by 1) outwardly directed gradients of Na+ or K+, and 2) the addition of vesicles equilibrated at pH 6.0 to 7.5 buffer. The rate of pH gradient dissipation was stimulated 6.3-fold by the replacement of tetramethylammonium gluconate by tetramethylammonium chloride. A further increase, of 2-fold, was seen upon the addition of carbonyl cyanide-m-chlorophenylhydrazine, demonstrating the existence of a Cl- conductance pathway. In the presence of valinomycin, the replacement of tetramethylammonium gluconate by K gluconate increased the rate of delta pH dissipation by 11-fold, demonstrating the existence of a conductive pathway for protons. This pathway for protons was also shown by the formation of an acidic interior space by an outwardly directed K gradient in the presence of valinomycin. The parallel conductive pathways for H+ and Cl- may dissipate pH and chloride gradients across the luminal membrane of the proximal tubule.

Acridine Orange↗

PubMed1994

Experimental evidence that rejection, but not transplantation, modulates coronary reactivity to direct and indirect vasodilation.

OBJECTIVE: To investigate the coronary response to direct and indirect vasodilation in a canine model of orthotopic heart transplantation because of the potential benefits of preserved vascular function during rejection. In cardiac transplants, reversal of vascular abnormalities is considered to be of prime importance for recovery from graft failure and rejection. DESIGN: Cardiac function and coronary bloodflow were monitored with electromagnetic flow probes. Hemodynamic data were collected either postoperatively, at the height of the recovery period, or during the severe rejection phase. Nitroglycerin (n = 7) as a 5 micrograms/kg intravenous bolus and diltiazem (n = 5) as a 150 micrograms/kg intravenous bolus were administered as direct stimulants of the coronary vasculature. Ouabain (n = 7), a digitalis derivative, at 20 micrograms/kg/min and calcium gluconate (n = 9) at 0.05 mEq/kg were given as indirect coronary vasodilators. Amrinone (n = 6), having both vasodilator and inotropic properties, was also studied (0.75 mg/kg intravenous bolus followed by a 200 micrograms/kg infusion). RESULTS: Under control conditions, all drugs significantly increased coronary bloodflow: nitroglycerin +47%, diltiazem +33%, ouabain +25%, calcium gluconate +36% and amrinone +65%. Coronary vascular resistance was reduced by a similar magnitude in all cases. In the rejection phase, ouabain and calcium gluconate, despite increasing stroke work, failed to induce significant changes in coronary bloodflow. Among the direct vasodilators used, only nitroglycerin augmented coronary perfusion (+38%) during rejection; the magnitude of its action on coronary vascular resistance was similar to that observed under control conditions. CONCLUSIONS: These results suggest that transplantation per se does not interfere with the response to either direct or indirect coronary dilation. Severe rejection blunted indirect coronary dilation. In these conditions, inotropic challenges appear to be detrimental. The observation that the coronary vasculature remained sensitive to nitroglycerin despite severe rejection suggested that a drug-specific coronary vasodilator reserve is still present. This study provides valuable arguments for the use of vasodilator therapy during graft rejection since rejection and ischemia are intimately related.

Amrinone↗

PubMedDate not supplied

Influence of copper, iron, and zinc on the physicochemical properties of parenteral admixture.

A parenteral admixture composed of 25% of 20% Intralipid, 25% of Azonutril 25, 37.5% of 30% Glucose and 12.5% of 50% Glucose was supplemented with copper, iron and zinc in the organic (gluconate) or inorganic (chloride) form at the following usual final concentrations: copper 0.24 mg/L, iron 0.50 mg/L, zinc 2.00 mg/L. The mixture was stored at 4 degrees C and at 25 degrees C for 24, 48, and 72 hours, and for one week. Determination of the pH indicated good stability of the mixture containing the trace elements in the gluconate form. A significant decrease in the pH of the mixture containing the trace elements as chlorides was noted after one week of storage at both temperatures. Particle size analysis revealed no significant variations between the two formulations after one week of storage. Flocculation kinetics confirmed the results obtained with the other two methods used to determine physicochemical stability. In addition, the kinetics indicated that the possibilities of coalescence processes are highly reduced in all cases. It may be concluded that the two type of mixtures remain stable for Seven days at 4 degrees C and 25 degrees C. However, mixtures containing trace elements in gluconate form should be chosen in cases of longer storage.

Chemistry, Pharmaceutical↗

PubMed1977

[Specificity of fungal alpha-glucosidases].

Studies of substrate and cosubstrate specificities of mould alpha-glucosidases suggest that the binding site of the active center of mould alpha-glucosidase consits of two subsites--glucone and aglucone ones. The glucone site is capable to bind glucose and mannose, whereas the aglucone one- some compounds whose affinity for the enzyme may be expressed as follows: glucose greater than galactose greater than paranitrophenol greater than or equal to glycerol greater than ethanol approximately equal to methanol. Upon interaction of enzyme with alpha-D-glucoside the formation of a productive enzyme-substrate complex occurs when the glucosyl residue located at the non-reducible end of the substrate molecule occupies the glucone subsite and aglucone of the substrate occupies the aglucone subsite of the enzyme. After removal of the first product from the aglucone subsite the substrate is bound at this subsite. It is assumed that under cosubstrate excess it is capable to bind at the aglucone subsite prior to the removal of the first product and the formation of the substituted form enzyme--glycosyl. Under these conditions the cosubstrate removes the substrate from the aglucone subsite resulting in a formation of a non-productive tertiary complex enzyme--substrate--cosubstrate. The anomeric configuration of glucose produced under the action of alpha-glucosidase on maltose and starch was determined using a kinetic method.

Aspergillus↗

PubMed1998

Short time effect of Chemiron (a combination iron preparation), single iron, and different magnesium salts on plasma. Magnesium concentration during early pregnancy in Nigerian women. A preliminary report.

Maternal magnesium requirements increase during pregnancy because of the synthesis of new tissue--both fetal and maternal. Magnesium takes part in almost 300 enzymatic reactions in the human body and regulates membrane permeability and protein bio-synthesis by promoting initiation and dissociation factors. The absorption velocity of magnesium differs from one tissue to another in animal experiments. It is highest in the liver, kidney, heart and is low in skeletal muscle, the brain and erythrocytes. It obeys and follows the Michaelis-Menten Kinetic law. 15 mmol of magnesium is consumed daily depending on the types of food takenin. The main sources of magnesium are vegetables and meats. Many Nigerian women are not able to afford enough of these. The amount of magnesium reabsorbed depends on the magnesium intake and not on magnesium needed which is about 10-40% of the intake. In this study, we examined the short-term effect of magnesium asphat HCL (614.18 mgMG), magnesium diasporal (magnesium citrate 610 mg + magnesium laevalitat 30 mg = 100 mg magnesium = 8.2 mval), ferrous gluconate (300 mg) plus folic acid and chemiron, a new combination hematinic agent (ferrous fumarate 300 mg, folic acid 5 mg, vitamin B12 10 mg, vitamin C 25 mg, magnesium sulfate 0.3 mg and zinc sulfate 0.3 mg) on plasma magnesium concentration during early pregnancy in Nigerian women. Significant increases of plasma magnesium concentrations were found in these groups (magnesium asphat HCL, 0.83 +/- 0.12 to 0.96 +/- 0.14 mmol/l, magnesium diasporal 0.843 +/- 0.14 to 0.891 +/- 0.14 mmol/l and chemiron 0.848 +/- to 0.866 +/- 0.16 mmol/l after five days. The ferrous gluconate and folic acid treated group showed no significant changes. This study shows that a chemiron supplement leads to increased magnesium plasma levels whereas ferrous gluconate and folic acid do not. These results suggest that the low level of magnesium is a normal physiological adjustment of pregnancy and that iron supplementation does not influence this unless magnesium salt is given.

Adult↗

PubMed1983

The use of calcium with verapamil in the management of supraventricular tachyarrhythmias.

Verapamil, a calcium channel blocking drug, terminates supraventricular arrhythmias but may have a negative inotropic effect and produce peripheral vasodilatation and hypotension. We studied the efficacy of intravenous calcium gluconate in reversing or preventing the hypotensive effect of verapamil in 31 patients with atrial tachyarrhythmias. In 21 instances, verapamil was given first, and in 13 calcium was used as pretreatment before the administration of verapamil. Calcium gluconate, when given as pretreatment, prevented the fall in blood pressure induced by verapamil, and when given after verapamil restored blood pressure to control values. The administration of calcium did not alter the antiarrhythmic effect of verapamil.

Adult↗

PubMed1986

Digital hydrofluoric acid burns: treatment with intraarterial calcium infusion.

Hydrofluoric acid (HF) produces a unique chemical burn due to tissue penetration by fluoride ion. Fluoride ion interferes with calcium activity in a variety of cell membranes and calcium-dependent processes, resulting in severe pain and deep tissue destruction. The currently accepted methods of treating HF burns include application of topical soaks or ointments with calcium or magnesium salts for minor burns and local injection of calcium gluconate for more severe burns. Digital burns also may require nail removal and direct injection into the nail bed. We present the cases of a series of patients with moderate to severe HF burns involving one or more fingers who were treated with selective intraarterial calcium infusion of dilute (1.66%) calcium salts. All patients had excellent relief of symptoms and marked improvement of the burn lesions following one to three four-hour infusions of calcium chloride or calcium gluconate. One patient required subsequent surgical intervention for grafting of a full-thickness burn, and one patient developed transient spasm at the site of percutaneous arterial line insertion. Intraarterial calcium infusion for the treatment of HF burns of the fingers provides many therapeutic advantages, including elimination of painful calcium injection directly into fingertips, avoidance of debilitating procedures such as fingernail removal, and assurance that all affected cells are receiving adequate amounts of calcium to replenish depleted stores and to complex with remaining free fluoride ion.

Adult↗

PubMed1987

Can blood pressure reduction induced by slow calcium channel blockade (verapamil) be reversed by calcium infusion?

The pressor effects of a single infusion of calcium gluconate (1375 mg) were measured in 20 patients, aged 31-63 years, with mild and moderate essential hypertension, being on long-term treatment with the slow calcium channel blocker verapamil. The calcium load induced a significant (P less than 0.001) increase in mean serum ionized calcium (from 1.24 +/- 0.01 to 1.40 +/- 0.2 mmol/l). This did not alter mean blood pressure or mean heart rate, although the individual patients responded differently to the mild hypercalcaemia; a significant fall in blood pressure being observed in a few patients. These results demonstrate the unpredictable effects of an increase in extracellular calcium on vascular smooth muscle cells and suggest that an intravenous bolus of 1375 mg calcium gluconate is not effective in counteracting the hypotensive action of verapamil.

Adult↗

PubMed1990

Stimulation of renin release by intrarenal calcium infusion.

The effects of intrarenal infusions of calcium gluconate (10 and 100 micrograms Ca/kg/min) on renin secretion were studied in anesthetized mongrel dogs. In one group, the two doses of calcium were infused for 30 minutes each (1 ml/min). In a second group, the same doses were administered 30 minutes after the start of infusion of prostaglandin synthesis inhibitors (indomethacin 10 micrograms/kg/min intrarenal or injection of meclofenamate 5 mg/kg i.v. bolus). Mean arterial pressure, renal blood flow, and glomerular filtration rate remained unchanged during the infusion of calcium in both groups. The infusion of 10 micrograms Ca/kg/min increased renin secretion 77% and sodium excretion 123%. During the infusion of 100 micrograms Ca/kg/min, renin secretion was not different from precalcium values, whereas urinary 6-keto-PGF1 alpha, urine flow, sodium, potassium, and calcium excretion rates were increased (p less than 0.05). During the administration of prostaglandin synthesis inhibitors, the urinary 6-keto-PGF1 alpha levels were reduced, and the infusion of 10 micrograms Ca/kg/min failed to increase renin secretion, sodium excretion, or 6-keto-PGF1 alpha excretion rates. The infusion of 100 micrograms Ca/kg/min during prostaglandin synthesis inhibition did not modify urine flow or sodium excretion; however, potassium and calcium excretions increased. It is concluded that 1) the intrarenal infusion of small doses of calcium gluconate is capable of stimulating renin secretion through a prostaglandin-mediated mechanism, and 2) the stimulation of renin secretion as well as the increase in sodium excretion induced by calcium are independent of hemodynamic alterations.

6-Ketoprostaglandin F1 alpha↗

PubMed1983

Arterial perfusion for hydrofluoric acid burns.

The perfusion method is briefly summarised: 1 An arteriogram (under brachial plexus block) is carried out, and the radial, ulnar or brachial artery chosen as infusion site, according to the location and extent of the damage. 2 The infusion is administered over 4 h: Radial or ulnar artery 10 ml 20% calcium gluconate in 40 ml normal saline, or brachial artery: 20 ml 20% calcium gluconate in 80 ml normal saline. 3 Heparin 200 u per kg body weight as long as the arterial catheter is in pace.

Burns, Chemical↗

PubMed1981

Comparative efficacy of injectable calcium and magnesium salts in the therapy of hydrofluoric acid burns.

Hydrofluoric acid (HF) causes severe skin burns which often progress in severity despite physiologic neutralization. The currently accepted therapy is the subcutaneous injection of calcium (Ca) gluconate to precipitate the residual free fluoride ion. Magnesium (Mg) also forms an insoluble fluoride salt and is less tissue irritating than Ca. This study compared the effects of subcutaneous injection of saline, Ca gluconate, Mg acetate (MgAc), and Mg sulfate (MgSO4) on lesions resulting from HF burns in rats. Burns treated with either Mg compound healed 3.7 +/- 1.7 days faster (p less than 0.05) developed less severe lesions (p less than 0.01) and exhibited left untreated or treated with saline. There was no difference in the incidence of infection between the study groups. The effects of burns treated with calcium were statistically similar to the control groups. This study suggests that Mg may be more effective than Ca in minimizing the duration, depth, and progression of dermal HF burns.

Animals↗

PubMed1989

[The effect of pharmacological agents on pancreatic incretory activity in patients with chronic pancreatitis].

In chronic pancreatitis with moderate derangements of carbohydrate tolerance (detected by the double glucose test), the basal concentrations of insulin and C-peptide in blood are normal whereas in patients with secondary diabetes mellitus are lowered. Glucagonemia is increased in patients of both groups. Euphylline (applied as an inhibitor of nucleotide phosphodiesterase), calcium gluconate and the adrenomimetic drug isadrin consistently increased insulinemia and the blood level of C-peptide in patients with chronic pancreatitis both with moderate and appreciable derangements of glucose tolerance. In patients with secondary diabetes that developed in the presence of pancreatitis, these drugs did not influence glucagonemia. The clinical prospects of the making use of the stimulating action of euphylline, calcium gluconate and isadrin on the function of beta-cells of the pancreas in chronic pancreatitis patients are under discussion.

Aminophylline↗

PubMed1984

Calcium supplementation during cardiopulmonary bypass in paediatric surgery.

This paper reports on the monitoring of plasma ionized calcium (Ca++) levels in children undergoing cardiopulmonary bypass (CPB) for open-heart surgery. The pump was primed with blood treated with either heparin or citrate-phosphate-dextrose (CPD). In certain cases calcium supplementation was used. In all cases a sudden drop in Ca++ levels took place at the start of CPB, followed by a slow recovery. In the patients who received heparinized blood the drop was slight (14%) and recovery fast (10 minutes), but in those who received CPD the drop was excessive (58%) and recovery was still incomplete after 1 hour despite supplementation with 0,5 g calcium gluconate per unit of whole blood. Different supplementation regimens were tried and the optimum was achieved by using 1 g calcium gluconate per unit of whole blood. This limited the drop in the Ca++ level to 42%, and recovery to prebypass levels took place within 45 minutes.

Anticoagulants↗

PubMed1979

Interaction of calcium, magnesium, and gastrin on gastric acid secretion.

A dose response study of the effect on gastric acid secretion of synthetic human gastrin-17 (SHG) in doses of 50, 200, and 500 ng/kg/hr was performed in 8 healthy volunteers. The study was repeated on separate days during i.v. infusion of magnesium sulphate (0.4 meq Mg2+/kg/hr), of calcium gluconate (0.1 meq Ca2+/kg/hr) and of magnesium sulphate plus calcium gluconate. Magnesium infusion resulted in an increase in the dose of SHG required for one-half maximal secretion (D50), whereas infusion of calcium decreased D50. The difference in D50 of SHG when administered in combination with magnesium and with calcium was significant. Combined infusion of SHG, magnesium, and calcium resulted in the same D50 of SHG as found when SHG was infused alone. The calculated maximal acid response was almost identical in the four experiments except for a minor but nonsignificant decrease during calcium infusion. The results indicate an interaction of calcium, magnesium, and gastrin on parietal cell function and extend the observations of others in intact humans as well as in isolated gastric mucosa.

Adult↗

PubMed1992

Zinc-induced copper deficiency in an infant.

OBJECTIVE: To describe the case of a 13-month-old girl who developed copper deficiency as a result of excessive zinc gluconate ingestion. SETTING: Tertiary care hospital in Syracuse, NY. INTERVENTIONS: Cessation of zinc ingestion followed by intravenous and oral copper chloride therapy. MEASUREMENTS/MAIN RESULTS: Ingestion of zinc gluconate, 120 mg/d for 6 months, and thereafter 180 mg/d for 1 month, preceded the clinical presentation of listlessness, anemia, neutropenia, poor weight gain, abnormal sparse hair, and scorbuticlike bone changes. Findings on a bone marrow examination included ring sideroblasts and suggested copper deficiency. Plasma zinc level was 36.7 mumol/L, serum ceruloplasmin level was 20 mg/L, and serum copper level was undetectable. Clinical and laboratory abnormalities resolved shortly after initiation of copper therapy. CONCLUSIONS: This case demonstrates the reciprocal relationship of copper and zinc metabolism and exemplifies the important interrelationships of dietary trace minerals.

Bone Diseases, Metabolic↗

PubMed2001

Performances of new sugar-bearing poly(acrylamide) copolymers as DNA sieving matrices and capillary coatings for electrophoresis.

We have synthesized two new sugar monomers, allylamine of gluconic and lactobionic acid, by opening the corresponding lactone ring with allylamine. These monomers were copolymerized with acrylamide leading to formation of copolymers with a relative molecular mass of 288000 and 180000 Da, respectively. Double-stranded DNA fragments were separated in entangled solutions of these linear polymers in capillary electrophoresis. Resolution, peak spacing and peak width were the parameters taken into account to evaluate the quality of the separation achieved with the new polymers. This work indicates that the copolymers of acrylamide and allyl gluconic acid have a high sieving capacity and provide a performance similar to that of hydroxyethylcellulose (HEC) of comparable viscosity. Unlike HEC, this copolymer selfcoats onto the capillary wall, allowing DNA fragments to be efficiently separated in an uncoated capillary.

Acrylamides↗

PubMed1995

Chloride is required for receptor-mediated divalent cation entry in mesangial cells.

Agonists which stimulate the inositol 1,4,5 trisphosphate ([1,4,5]-IP3)-dependent mobilization of Ca2+ from intracellular stores also stimulate entry of divalent cations across the cell membrane. Under appropriate experimental conditions, divalent cation entry across the cell membrane can be monitored as the rate at which the intracellular fluorescence of divalent cation indicators is quenched by the addition of Mn2+ to the extracellular medium. We report that addition of vasopressin to fura-2-loaded glomerular mesangial cells in culture markedly accelerated the rate at which Mn2+ quenched fura-2 fluorescence at its Ca(2+)-insensitive wavelength in the presence of extracellular NaCl, but that this quench response was attenuated when Cl- was removed from the extracellular medium by equimolar substitution with impermeant anions (gluconate, methanesulfonate, acetate, lactate). Similarly, loss of agonist-induced quench also occurred when Cl- was substituted with gluconate in K(+)-containing media. Addition of the Cl- channel inhibitor, 5-nitro-2-(3-phenylpropylaminobenzoic acid) (NPPB), also inhibited Mn(2+)-induced quench of fura-2 fluorescence following vasopressin addition. In contrast, in the presence of gramicidin to provide an alternate conductance pathway to accompany divalent cation entry, agonist-dependent Mn2+ quench occurred even in the absence of extracellular Cl-, indicating that the requirement for Cl- was not the result of cotransport on a common transporter nor the result of Cl- serving as a necessary cofactor for divalent cation entry. A similar dependence on extracellular Cl- was observed for other Ca(2+)-mobilizing agonists such as endothelin, as well as the intracellular Ca2+ ATPase inhibitor, thapsigargin. Extracellular Cl- dependence for agonist-induced divalent cation entry was also reflected in a corresponding extracellular Cl- dependence for agonist-induced mesangial cell contraction. It has been previously shown by ourselves (Kremer et al., 1992a, Am. J. Physiol., 262:F668-F678) and others that agonist-stimulated calcium mobilization in mesangial cells is accompanied by inhibition of K+ conductance and increased Cl- conductance. Accordingly, we conclude that the current findings suggest that activation of Cl- conductance provides regulated charge compensation for receptor-mediated divalent cation entry in response to Ca(2+)-mobilizing vasoconstrictor agonists in mesangial cells.

Animals↗