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[Premedication for the prevention of adverse reactions to ionic iodized contrast media. Comparative study].

A study comparing two pretreatment protocols to prevent adverse reactions to iodinated radiocontrast media (IRCM) was performed in 45 adults patients. They followed inclusion and exclusion criteria. Pretreatment protocol A was within 12 hours before using the IRCM and pretreatment protocol B was for 72 hours before. A corticosteroid and two H2 receptor antagonists were given on both protocols. We managed these protocols by an aleatory way, so 22 patients received protocol A and 23 patients received protocol B. Excellent results were found in 63.6% and good results were found in 36.4% for protocol A. Excellent results were found in 78.2% and good results were found in 21.8% for protocol B. However, no statistically differences were detected for both protocols (p = 0.451).

Adolescent↗
PubMed1994

Hemodynamic and anesthetic effects of etomidate infusion in medetomidine-premedicated dogs.

Hemodynamic and analgesic effects of medetomidine (15 micrograms/kg of body weight, IM) and etomidate (0.5 mg/kg, IV, loading dose; 50 micrograms/kg/min, constant infusion) were evaluated in 6 healthy adult Beagles. Instrumentation was performed during isoflurane/oxygen-maintained anesthesia. Before initiation of the study, isoflurane was allowed to reach end-tidal concentration < or = 0.5%, when baseline measurements were recorded. Medetomidine and atropine (0.044 mg/kg) were given IM after recording of baseline values. Ten minutes later, the loading dose of etomidate was given IM, and constant infusion was begun and continued for 60 minutes. Oxygen was administered via endotracheal tube throughout the study. Analgesia was evaluated by use of the standard tail clamp technique and a direct-current nerve stimulator. Sinoatrial and atrial-ventricular blocks occurred in 4 of 6 dogs within 2 minutes after administration of a medetomidine-atropine combination, but disappeared within 8 minutes. Apnea did not occur after administration of the etomidate loading dose. Analgesia was complete and consistent throughout 60 minutes of etomidate infusion. Medetomidine significantly (P < 0.05) increased systemic vascular resistance and decreased cardiac output. Etomidate infusion caused a decrease in respiratory function, but minimal changes in hemodynamic values. Time from termination of etomidate infusion to extubation, sternal recumbency, standing normally, and walking normally were 17.3 +/- 9.4, 43.8 +/- 14.2, 53.7 +/- 11.9, and 61.0 +/- 10.9 minutes, respectively. All recoveries were smooth and unremarkable. We concluded that this anesthetic drug combination, at the dosages used, is a safe technique in healthy Beagles.

Adrenergic alpha-Agonists↗
PubMed1994

[Omeprazole/amoxicillin: impaired eradication of Helicobacter pylori in smoking but not in premedication with omeprazole].

The efficacy of high dose omeprazole/amoxicillin (OME/AMOX) for eradication of Helicobacter pylori (HP) is controversial. Reported eradication rates range from 0% to 90%. Different therapy schedules and unknown factors may be crucial; in particular, pretreatment with OME has been thought to endanger HP eradication by subsequent OME/AMOX. Preliminary findings suggested that smoking may impair eradication with OME/AMOX. The aims of this study were (1) to establish whether HP eradication rates differ depending on whether eradication with OME/AMOX was performed before or after ulcer therapy with OME, (2) to determine whether smoking impairs HP eradication by OME/AMOX and (3) to evaluate the efficacy of OME/AMOX in our population. 52 HP positive outpatients with endoscopically documented recurrent duodenal ulcer were included. Exclusion criteria were: alcoholism, previous gastric surgery, or intake of antibiotics, OME, bismuth salts, corticosteroids and NSAIDs within four weeks before study entry. Patients currently smoking > 10 cigarettes/day were classified as smokers. HP infection was confirmed by histology (3 biopsy specimens from the gastric antrum and 2 from the gastric body; H&E, Giemsa) and at least positive rapid urease test (CLO) or culture. Eradication therapy consisted of oral OME (40 mg bid) and AMOX solute (750 mg tid) for 10 days (OME/AMOX). This therapy preceded (group A) or followed (group B) ulcer therapy with OME (20 mg per day for 20 days). In group A 17 patients (2 females, 15 males, mean age 39 [19-70]; 11 smokers, 6 nonsmokers) underwent ulcer therapy with OME (d 1-20) before OME/AMOX d 21-30).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Hemodynamic and analgesic effects of propofol infusion in medetomidine-premedicated dogs.

Hemodynamic and analgesic effects of medetomidine (30 micrograms/kg of body weight, IM), atropine (0.044 mg/kg, IM), and propofol (2 mg/kg, IV, as a bolus, and 165 micrograms/kg/min, IV, for 60 minutes, as an infusion) were evaluated in 6 healthy adult Beagles. Catheters were placed while the dogs were anesthetized with isoflurane in oxygen. Administration of isoflurane was then discontinued, and dogs were allowed to breath oxygen until end-tidal isoflurane concentration was < or = 0.5%. At this time, baseline measurements were recorded and medetomidine and atropine were administered. Ten minutes later, the bolus of propofol was given and the infusion was begun. Analgesia was evaluated with a tail clamp test and by use of a direct-current nerve stimulator. Sinoatrial and atrioventricular blockade developed in all 6 dogs within 2 minutes of administration of medetomidine and atropine, but disappeared within 10 minutes. Apnea did not develop after administration of propofol. Analgesia was strong and consistent throughout the entire 60-minute period of propofol infusion. Medetomidine significantly (P < 0.05) increased systemic vascular resistance and decreased cardiac output, compared with baseline values. Propofol infusion appeared to alleviate medetomidine-induced vasoconstriction. Recovery was smooth and uncomplicated. All dogs were able to walk normally at a mean time (+/- SEM) of 88.2 +/- 20.6 minutes after termination of propofol infusion. It was concluded that medetomidine, atropine, and propofol, as given in the present study, is a safe combination of anesthetic drugs for use in healthy Beagles.

Analgesics↗
PubMed1993

Evaluation of ondansetron as a drug for premedication.

The potency of Ondansetron (Zofran, Glaxo), a highly specific 5HT3 antagonist in preventing the very unfavorable complication during introducing anesthesia, i.e. a Bezold-Jarisch reflex-like reaction, was studied in a clinical trial. A total of 20 patients (12 males and 8 females aged 19-65 years) admitted for clinical surgical treatment participated in the trial. Zofran (8 mg in 500 ml Ringer solution) was injected intravenously one hour before intubation at a flow rate of 8 ml. min-1. Systolic and diastolic blood pressure, central venous pressure, breathing frequency and minute ventilation, pCO2 and pO2 in venous blood, electrocardiogram monitoring (ECG) and several common features such as spontaneous muscle activity, palpebral reflexes, skin and mucose surfaces were continuously observed. Visual, auscultatory and X-ray control of the lungs was effected. It was found that blockade of 5HT3 receptors prevented the appearance of Bezold-Jarisch reflex-like reaction. The drug could successfully be used in anesthesiological practice.

Adult↗
PubMed1993

[Flumazenil, a benzodiazepine antagonist, in endoscopic premedication].

Midazolam is the benzodiazepine recommended for anaesthesia induction when an early recovering is desirable. Flumazenil, which is also a hydrosoluble imidazobenzodiazepine, improves the safety of the forhere one because it immediately reduces the degree of sedation. With this purpose, this last drug has been studied in 25 patients who had been previously treated with Midazolam in order to carry out different endoscopic studies. The Flumazenil average dose used was 0.276 mg and the conscience recovering after its intravenous injection, evaluated by a simple oral numeric regression test, oscillated between 60 and 300 seconds with an X of 96 seconds. Once the study was finished, all patients were discharged from hospital after two-hour observation, except for one patient (4%) who suffered a complication and so was discharged after a twenty-four-hour control. No doubt the advent of a drug opposed to benzodiazepine receptors used in anaesthetic induction shows the possibility of a quick recovering and moreover. Quicker discharge from hospital.

Adult↗