Int J Clin Pharm Th
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Int J Clin Pharm Th · May 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparative study of oral clonidine and diazepam as premedicants in children.
In a prospective, double-blind, controlled study the efficacy of clonidine was assessed in children, with respect to sedation, intubation response, and recovery. Fifty children, aged 4-12 years, undergoing general anesthesia were studied. Twenty-five children (group I) received oral diazepam) 0.2 mg/kg and another 25 children (group II) received oral clonidine 3 micrograms/kg, 90-120 minutes before induction of anesthesia. ⋯ The recovery with clonidine was not delayed (p < 0.01). Clinically significant hypotension and bradycardia were not observed in any of the patients. We conclude that clonidine 3 micrograms/kg produces sedation comparable to diazepam 0.2 mg/kg and also attenuates the intubation response without increasing the incidence of complications.
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Int J Clin Pharm Th · Apr 1997
Randomized Controlled Trial Clinical TrialPharmacokinetics of ketorolac in children after abdominal surgery.
The pharmacokinetics of 2 doses of intravenous ketorolac (0.5 and 0.9 mg x kg-1) were studied in 14 children (age 2-8 years). A single dose of the drug was injected into the dorsum vein of one hand. Blood samples were collected at regular time intervals for 6 hours. ⋯ The distribution volume (Vdarea), the total clearance (Cltotal), and elimination half-life (t1/2 beta) were similar in both groups of children who either received 0.5 or 0.9 mg x kg-1 of ketorolac. The estimated geometric mean Vdarea, Cltotal, and t1/2 beta ratios (95% CI in parentheses) for 0.9 mg x kg-1:0.5 mg x kg-1 were 1.24 (0.82, 1.50), 1.14 (0.88, 1.23), and 1.083 (0.40, 1.81), respectively. The pharmacokinetic parameters found in this study are different from those found by other authors in adult subjects.
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Int J Clin Pharm Th · Apr 1997
Concentration-effect relationship of delta-9-tetrahydrocannabiol and prediction of psychotropic effects after smoking marijuana.
On the basis of a publication by Cochetto et al. [1981] we performed simulations of the effect-time course (high-rating) after smoking marijuana. The intention was to characterize the concentration-effect relationship of THC and to provide information on how long psychotropic effects (and therefore impairment of cognitive or motoric functions) last after intake of a cannabinoid product. The parameter estimates (+/-SD) of the pharmacokinetic disposition and the pharmacodynamic model (sigmoidal Emax model) after smoking 1 marijuana cigarette containing 9 mg THC were as follows: T/2 alpha = 5 minutes (+/-1.2), T/2 beta = 75 minutes (+/-23), Teq (equilibrium half-life with the effect site) = 29 minutes. (+/-2), ECe50 = 7.2 ng/ml THC (+/-0.5), E0 (baseline high rating) = 18% (+/-2.0), Emax (amplitude of the high rating) = 23% (+/-2.5), Hill coefficient = 9.0 (+/-3.0). ⋯ In conclusion, our simulations show that dose and dosing interval are determinants of the duration of the psychotropic effects of THC. These simulations may be beneficial for the interpretation of THC levels, e.g. associated with accidents or traffic violations. Furthermore, misuse of natural hemp with a low THC content seems unlikely.
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Int J Clin Pharm Th · Mar 1997
Interobserver agreement: Cohen's kappa coefficient does not necessarily reflect the percentage of patients with congruent classifications.
A widely accepted approach to evaluate interrater reliability for categorical responses involves the rating of n subjects by at least 2 raters. Frequently, there are only 2 response categories, such as positive or negative diagnosis. The same approach is commonly used to assess the concordant classification by 2 diagnostic methods. ⋯ Therefore, it may be of limited value in the assessment of increases in the interrater reliability due to an improved diagnostic method. The percentage of patients with congruent classifications is of easier clinical interpretation, however, does not account for the percent of agreement expected by chance. We, therefore, recommend to present both, the percentage of patients with congruent classifications, and Cohen's kappa coefficient with 95% confidence limits.
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Int J Clin Pharm Th · Oct 1996
Case ReportsRelapse and elevation of blood urea nitrogen in acute fenitrothion and malathion poisoning.
We observed 6 patients with severe fenitrothion and/or malathion poisoning necessitating artificial ventilation and intensive care monitoring. Three developed relapse following acute cholinergic crisis. In these patients the blood urea nitrogen (BUN) abnormally elevated before the development of relapse and the initial high concentration of plasma organophosphate (OP) decreased only gradually. ⋯ This observation was confirmed in a retrospective search of 14 patients. In addition, erythrocyte cholinesterase (EChE) activities were more helpful to diagnose the development of relapse than plasma cholinesterase activities. Therefore, careful monitoring of BUN in addition to plasma OP concentration may be useful to predict the development of relapse.