European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Jan 1987
Comparative StudyDifferences in diazepam pharmacokinetics in Chinese and white Caucasians--relation to body lipid stores.
We have compared diazepam pharmacokinetics in 16 Chinese and 18 white Caucasian healthy male volunteers, resident in Hong Kong and have correlated them with physical attributes. Serum concentrations of diazepam and desmethyldiazepam were measured in venous blood by an enzyme-linked immunoassay (0-3 h samples) and HPLC (3-72 h samples). Pharmacokinetic parameters were derived assuming a two compartment model, distribution phase less than 6 h, and 100% oral systemic availability. ⋯ Mean peak diazepam concentration (Cmax) was similar in both ethnic groups. Time to Cmax (tmax) was more often prolonged in the Chinese (chi 2 test, p = 0.01). Body fat and stature may thus account for these inter-ethnic differences in the apparent volume of distribution of diazepam, a highly lipid-soluble drug.
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Eur. J. Clin. Pharmacol. · Jan 1986
Randomized Controlled Trial Clinical TrialExtradural and parenteral pethidine as analgesia after total hip replacement: effects and kinetics. A controlled clinical study.
Twenty-one patients who had undergone total hip replacement were randomly assigned to one of three groups in order to compare a single dose of 1 mg/kg of pethidine im (I) and 20 mg (II) or 60 mg of extradural pethidine (III) in a double-blind design. The degree of analgesia, the adverse effects, and the kinetics were studied for 18 h. Pain was monitored using a visual analogue scale (VAS). ⋯ The terminal half-lives and plasma clearances of pethidine, and the time to peak concentration were not different between the groups. Single patients in the extradural groups showed hypoalgesia to pin prick in parallel to the effect. The present study shows that extradural pethidine produces shortlived analgesia, in contrast to the long-lasting effect of morphine found in other studies.
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Eur. J. Clin. Pharmacol. · Jan 1986
Patient-controlled analgesia with nalbuphine, a new narcotic agonist-antagonist, for the treatment of postoperative pain.
Patient-controlled analgesia (PCA, intravenous self-application of narcotics) has been studied during the early postoperative period in 40 ASA I-III patients recovering from elective major and minor surgery (20 abdominal and 20 orthopaedic operations). Doses of 3.7 mg of the new agonist-antagonist opioid analgesic nalbuphine were available on demand, whenever the patients felt that pain relief was necessary, delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC) in response to use of a patient-controlled manual switch. The maximum dose/h was set at 28.2 mg, with a refractory time of 1 minute between successful demands. ⋯ Side effects (nausea, sweating) occurred in about 10% of patients but were usually of minor intensity. No serious circulatory or respiratory problems were observed during the period of PCA. Patient-controlled analgesia is a promising technique for the treatment of acute pain and for clinical pain research.
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Eur. J. Clin. Pharmacol. · Jan 1986
Clinical Trial Controlled Clinical TrialHaemodynamic effects of atenolol, pindolol and propranolol during adrenaline infusion in man.
In a double blind, cross over study the haemodynamic effects of an i.v. infusion of adrenaline during concomitant administration of atenolol, pindolol, propranolol or placebo were examined in 7 healthy volunteers. During coadministration with placebo, adrenaline caused an increase in systolic blood pressure (SBP) of 26 mm Hg and a decrease in diastolic blood pressure (DBP) of 20 mm Hg. Heart rate (HR) and stroke volume (SV) were increased by about 20-30%. ⋯ The haemodynamic response to adrenaline during coadministration of propranolol was very similar to that seen after pindolol. It is concluded that a beta1-selective blocker interferes very little with the haemodynamic response to adrenaline, whereas it is changed to a pure pressor response during coadministration of a non-selective betablockers. ISA did not significantly modify the pressor response.
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Eur. J. Clin. Pharmacol. · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialAcute effects of antiarrhythmic drugs on stable ventricular premature beats. Controlled comparison of lorcainide and lidocaine.
Nineteen patients with refractory but stable ventricular premature beats (VPB) received 3 medications intravenously at 24-h intervals. Lorcainide (2 mg/kg) and placebo were given double-blind in randomized sequence and the third treatment was 100 mg lidocaine, the standard reference drug. Continuous ECG recordings were made for the first 2 hours after administration to study the antiarrhythmic effect; the stability of the arrhythmia, the absence of residual and of period effects, and the interdrug differences in efficacy were statistically evaluated. ⋯ The median individual peak reduction in VPB was 96% for lorcainide and 47% for lidocaine. No significant reduction in VPB was observed with placebo. Adverse effects were acceptable with either active treatment.