Arch Intern Med
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Randomized Controlled Trial Comparative Study Clinical Trial
Absence of drug interaction between heparin and nitroglycerin. Randomized placebo-controlled crossover study.
The purpose of this randomized crossover study was to determine whether nitroglycerin interacts with heparin in terms of its anticoagulative properties as determined by activated partial thromboplastin time and thrombin time. Eight healthy adults were given either a 60-minute intravenous infusion of 5 mg of nitroglycerin or a 0.9% sodium chloride solution subsequent to the administration of an intravenous injection of 5000 U of heparin. No nitroglycerin-related drug interference with heparin was observed as measured by the activated partial thromboplastin time and the thrombin time.
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Clinical Trial Controlled Clinical Trial
The effect of oral bases on enteral aluminum absorption.
Physicochemical considerations suggest that citrate may potentiate gastrointestinal aluminum absorption via the formation of an aluminum citrate moiety. We tested this hypothesis and also studied whether sodium bicarbonate would have a similar effect. Eight healthy adults each partook of four oral regimens: aluminum alone, aluminum plus sodium bicarbonate, aluminum plus citrate (as Shohl's solution), and citrate alone. ⋯ The rise in urinary aluminum obtained with aluminum plus Shohl's solution, however, was nearly eight times that seen with either aluminum alone or aluminum plus sodium bicarbonate (327 micrograms vs 45 micrograms and 41 micrograms, respectively). Citrate thus appears to augment gastrointestinal aluminum absorption markedly, an effect not shared by an equivalent dose of sodium bicarbonate. Citrate administration to patients with renal failure who are also taking aluminum-containing medication may be harmful.
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Seventeen patients with malignant hypercalcemia were treated with a combination of a single dose of 3-amino 1-hydroxypropylidene-1-bisphosphonate (APD [also known as AHPrBP or palmidronate disodium]) and salmon calcitonin given as suppositories for 3 days. To assess whether such a combined short treatment has a significant benefit leading to earlier normalization of the plasma calcium level than does APD alone, 17 additional patients matched for the type of tumor, initial plasma calcium level, urinary hydroxyproline level, and the dose of APD served as controls. All patients receiving the combination of calcitonin and APD achieved normalization of the plasma calcium level within 9 days, with a decrease from 3.22 +/- 0.90 mmol/L (mean +/- SEM) to 2.29 +/- 0.03 mmol/L. ⋯ There were no side effects of both treatments, in particular neither flushing nor nausea induced by the suppositories of calcitonin. Clinical Improvement occurred after 2 days in the group receiving the combined treatment. In conclusion, the combined treatment is rapidly effective and safe in the treatment of patients with hypercalcemia, particularly when the notional setting of renal tubular reabsorption of calcium is increased and a rapid correction of the plasma calcium level is needed.