Antibacterial activity and pharmacokinetic behavior of cefazolin as compared with five other cephalosporin antibiotics.
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Isothermal crystallization of D,L-sodium-ammonium tartrate with traces of different impurities admixed shows that the added chiral contaminations produce a preferential crystallization of the tartrate isomer of same handedness. The critical lowest concentration of effective seeding agents is 0.1-0.5%. 1% optically active excess material induces 1.0-3.6% optical purity in the deposited crystals. An analysis of the relevant data reported so far gives similar figures in different crystallization systems. The relation of the results to the suggested lattice energy difference between enantiomers is discussed.
A comparison was made of three drug regimens: imipramine (Tofranil)/propantheline, oxybutynin (Ditropan) and penthienate bromide (Monodral). Two comparative trials were performed in prospective studies, using a randomization and cross-over design. All the drugs were found to improve the urinary symptoms and urodynamic changes associated with the unstable bladder, but penthienate was shown to be more effective than imipramine/propantheline. Its effect on the unstable bladder was equivalent to that of oxybutynin. Side-effects were common and most common with oxybutynin. However, the inability of these drugs to prevent the uninhibited detrusor contractions of the unstable bladder consistently and objectively was demonstrated.
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The sonographic findings in the bladder are presented in four children with myelomeningocele and neurogenic dysfunction of the bladder, who were treated with intermittent self-catheterization and intravesical oxybutinin chloride. All were referred for routine sonography of the urinary tract. Each had infused a crushed tablet of oxybutinin chloride intravesically 30-120 min before the examination. In two children, brightly echogenic, non-shadowing particles were suspended in the bladder urine. In one of these, the particles swirled giving the impression of a "snowstorm"; in the other, most of the particles gradually settled forming an irregular clump on the bladder base. In the remaining two children, the urine appeared diffusely hazy with innumerable tiny particles giving the impression of a fine mist filling the bladder. The sonographic appearance of the urine in the bladder after intravesical instillation of crushed tablets can be dramatic and can simulate pus, blood, fungus, or other debris in the bladder lumen. In the absence of clinical symptoms or hematuria, a history of recent infusion of medication into the bladder should be sought.
The factors underlying the formation of Ca-phosphate and struvite calculi, as well as the present possibilities for oral and local therapy, their advantages and drawbacks are discussed in the light of published evidence. In this context a clinical case of multiple injuries is reported in which practically complete chemolitholysis has been achieved by combined oral and local therapy. The rapid growth of the calculi and their alarming tendency to recurrence in case of inadequate treatment is emphasized. The therapeutic method used in this case is regarded as suitable for practical purposes.
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Ditropan (oxybutynin chloride), a tertiary amine with slight anticholinergic and marked "papaverine-like" direct spasmolytic effects has been administered to 25 patients with idiopathic hyperactive bladder function. The drug reduced voiding frequency and abolished urgency. Control cystometry confirmed a significant increase in bladder capacity. Oral dryness was a tolerable side effect.
A total of 216 patients with voiding disorders were treated with oxybutynin and the effects and side effects were studied. The drug is effective in a wide variety of disorders. Good results were obtained in 66% of patients who had no previous treatment and in 46% of patients who had taken various drugs before. It was just as effective in all age groups. Twenty-three per cent of patients experienced side effects and 10% were unable to tolerate the drug. It is concluded that oxybutynin is an effective drug in the treatment of unstable bladder and disorders such as catheter-induced spasms.
The results of an investigation dealing with the therapy of instability of the detrusor using oxybutynin hydrochloride are presented. Out of an unselected group of patients 21 were enrolled in the trial. After therapy 19 patients showed significant improvement of subjective symptoms and objective urodynamic parameters. Twenty patients reported on tolerable side effects.
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