International journal of clinical pharmacology, therapy, and toxicology
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Int J Clin Pharmacol Ther Toxicol · Jan 1988
ReviewPropofol, the newest induction agent of anesthesia.
Propofol is a rapidly acting intravenous anesthetic agent which has many advantageous kinetic properties explaining its usefulness by bolus dose for induction of anesthesia or for administration by continuous intravenous infusion. It is rapidly distributed in the body with a half-life of only around 2 min and has an efficient hepatic and extrahepatic clearance (total body clearance may exceed liver blood flow). Premedication has little effect on the already good induction characteristics of propofol. ⋯ Propofol has proved to be a useful induction agent regardless of the age of patients, but in the elderly there appears to exist a marked sensitivity to it. Up to now there is no evidence that propofol in emulsion drug form can produce allergic or anaphylactoid reaction more often than other induction agents in use and no severe hematological nor visceral toxicity have been reported. In the present situation, when althesin is not marketed any more due to a high frequency of anaphylactoid reactions and etomidate will have a limited use in clinical practice because of its blocking effect on adrenocortical function, propofol offers an important alternative anesthetic agent to thiopentone.
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Int J Clin Pharmacol Ther Toxicol · Feb 1987
Pharmacokinetic and clinical evaluation of ketamine administered by i.v. and epidural routes.
The evolution of the plasma levels of ketamine and its two biotransformation products, norketamine (metabolite I) and dehydronorketamine (metabolite II) was studied after i.v. and epidural administration at doses of 2 and 5 mg/kg, respectively. The results show a good access capacity of ketamine from the epidural space to the systemic circulation as reflected in the high value of its apparent incorporation constant (ka = 5.54 +/- 2.33 h-1) and its good bioavailability (F = 0.77 +/- 0.22). The evaluation of clinical parameters points to a more attenuated cardiovascular and respiratory response after administration of the anesthetic by the epidural route.
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Int J Clin Pharmacol Ther Toxicol · Sep 1986
Clinical Trial Controlled Clinical TrialDihydroergotamine therapy in orthostatic hypotension due to psychotropic drugs.
A double-blind, placebo controlled study with 10 mg per day dihydroergotamine in patients with orthostatic hypotension induced by treatment with psychotropic drugs showed a significant effect in preventing immediate drop in blood pressure after standing up. Preventing an abrupt drop in blood pressure with change of posture hinders symptoms of dizziness and faintness and helps activating patients who otherwise prefer to stay in bed.
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Int J Clin Pharmacol Ther Toxicol · May 1986
Randomized Controlled Trial Comparative Study Clinical TrialSaccadic eye movements in determination of the residual effects of the benzodiazepines.
Saccadic eye movements and the volunteers' subjective assessments were used in the determination of the residual effects of a single high evening dose of flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg as well as in that of placebo. Sleep inducing and maintaining effects were subjectively assessed, too. Both flunitrazepam 2 mg, midazolam 30 mg, and lorazepam 2.5 mg possessed sleep inducing and increasing effects (n = 9), but in the number of nocturnal awakenings and quality of sleep no significant differences between placebo and the active medications were reported. ⋯ After three repeated 2 mg evening doses, flunitrazepam accumulated in the serum of the volunteers (n = 6), but the effect on saccadic eye movements as well as subjective side effects began to decrease already after one day's treatment. Thus, saccadic eye movement recording proved to be a useful tool in determining the residual effects and development of tolerance of benzodiazepines. No correlation was detected between the serum levels (radioreceptor assay) and saccadic eye movement recordings or subjective residual sequelae.
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Int J Clin Pharmacol Ther Toxicol · Nov 1985
Randomized Controlled Trial Comparative Study Clinical TrialPostextraction pain relief in children: a clinical trial of liquid analgesics.
Our objective was to evaluate the relative efficacies of four liquid analgesics in children, five to twelve years of age, following dental extractions. The analgesics, acetaminophen elixir (240 or 360 mg), acetaminophen with codeine elixir (240 mg and 24 mg, respectively), aluminum ibuprofen suspension (200 mg), and placebo liquid were administered at home, as a single dose, in a randomized double-blind study design. Of the 154 patients enrolled, 45 were evaluated, 39 patients never required medication, 12 were lost to follow-up, and 8 were excluded for other reasons. ⋯ The global rating of drug efficacy was statistically superior for aluminum ibuprofen. The majority of patients in all four groups were pain-free after four hours. No adverse reactions were reported during the study.