Australian and New Zealand journal of medicine
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Comparative Study Clinical Trial
The effects of enteric coating of aspirin tablets on occult gastrointestinal blood loss.
The effect of enteric coating of aspirin tablets on the gastrointestinal blood loss associated with high dose aspirin therapy was investigated in 12 patients with rheumatoid arthritis. Occult blood loss was measured after labelling the patients' red blood cells with Cr51. Three salicylate preparations were used: enteric coated tablets of aspirin ("Rhusal", G. ⋯ The bioavailability of the salicylate preparations was studied in seven of the 12 patients. Mean plasma salicylate concentration two hours after the second daily dose during dosage with the enteric coated tablets of aspirin was 118 +/- 15 microgram/ml compared to 131 +/- 16 microgram/ml during dosage with the uncoated tablets. Urinary recoveries of the daily dosage of aspirin in the two formulations were also similar.
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Myxoedema coma is fortunately rare and is probably rarer in a warm climate such as Australia. It carries a high mortality rate. Its correct management is still a controversial issue. ⋯ There was an improvement in body temperature within six hours of the first dose; this was accompanied by a brisk fall in serum CPK and cholesterol with a rapid rise of plasma T3 into the euthyroid range. There was a defect in water excretion which was rapidly reversed as renal function returned to normal. Review of the literature suggests that low dose oral therapy with T3 is a satisfactory form of initial management.
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The bioavailability and gastrointestinal site of release of enteric coated aspirin tablets ("Rhusal", G. P. Laboratories) were investigated following dosage with single tablets. ⋯ All these tests were consistent with the designed function of the enteric coating. The time course of concentrations of salicylate in saliva rather than in plasma was confirmed as a useful technique for the evaluation of different formulations of aspirin. The acceleration of gastric emptying by metoclopramide is a useful technique for the evaluation of enteric coated tablets.