Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Elevated drug concentration (DC) can be caused by intentional or iatrogenic overdoses and sampling technique errors. This study examined, in vitro, technique factors that can cause and prevent false elevations of DCs when drugs are administered through the catheter lines from which blood samples are later taken for DC analysis. Digoxin, aminophylline, and phenytoin were administered through central catheters in concentrations simulating those used clinically. Drug solution remained in the lumen for a time similar to that encountered clinically, then either remained in the tubing or was flushed out with 5 ml of normal saline (NS). After 6 h, a 5-ml sample was withdrawn for DC analysis (the tip of the catheter placed in NS, which represented blood supply). Prior to final sample withdrawal, 5 ml of NS was drawn through half of the lines and discarded to simulate methods used to prevent contamination. Thus, various flushing/no flushing and sample discarding/no discarding techniques were analyzed. When diluted concentrations of drug were administered, minor artifactual DCs were observed unless the line was not flushed or sample fluid discarded prior to final sampling. With undiluted drug administration, only flushing after the dose and discarding a sample prior to final sampling prevented artifactual DCs. Clinicians should be aware of the potential for such artifactual elevations of DCs and should encourage techniques that prevent their occurrence.
Ther Drug Monit 1991 Sep
PMID:Effect of monitoring drug concentrations through lines used to administer the drugs: an in vitro study. 195 38

During the course of a pharmacokinetic study of the antibiotic mezlocillin, we observed an interfering peak in the high pressure liquid chromatographic analytical procedure that was identified as benzyl alcohol. The benzyl alcohol interferent was traced to a preservative in heparin and saline solutions used to flush heparin locks and indicated that the heparin lock purge volume was inadequate to clean the flushing solution. The present study uses this as a model to study the amount of dilution and contamination interference observed in a controlled study where the purge volume was varied for two "real situation" concentrations of benzyl alcohol in the flush solution. It was found that only 0.5 ml of purge must be drawn to avoid significant contamination interference if benzyl alcohol-free saline is used for dilutions. Contamination interference from benzyl alcohol can also be avoided by spectroscopic or chromatographic resolution if the interference is identified and the particular analyte in question can be resolved. The results of this study provide valuable information for any study in which heparin locks are used and especially in procedures where benzyl alcohol may interfere with the method of analysis. If saline containing benzyl alcohol is used for the dilution of heparin solutions, 1.0 ml of purge must be drawn.
Ther Drug Monit 1987 Dec
PMID:Benzyl alcohol interference from heparin lock flush solutions in a high pressure liquid chromatographic procedure for mezlocillin. 342 13

We determined how often and for how long usable pressure waveforms were unavailable from a radial intraarterial pressure cannula during anesthesia and surgery in 41 patients. During cardiac surgery with a continuous flush system, usable arterial pressure was unavailable 8.7% of the time. It was unavailable 9.1% of the time during noncardiac surgical procedures with a continuous flush system, and 14.7% of the time in system without continuous flush. Thus, the use of a continuous flush device improves intraarterial pressure availability. Artifact is the principal contributor to unavailability, followed by flushing and blood sampling. With rare exceptions the use of a Riva-Rocci cuff for occasional return-to-flow maneuvers on the same arm as the intraarterial cannula reduces intraarterial pressure availability only slightly, certainly not enough to detract from its usefulness in providing an estimation of systolic pressure during intraarterial pressure monitoring.
J Clin Monit 1985 Jan
PMID:Availability of intraarterial pressure waveforms from catheter-manometer systems during surgery. 409 85

This study was conducted to evaluate the clinical efficacy of intravenous (i.v.) magnesium sulphate 2 gm bolus in sustained supraventricular tachycardia (SVT) and atrial flutter-fibrillation with fast ventricular rate of more than 160/min (AF-FVR) and to compare it with i.v. verapamil 5 mg. In this randomised controlled trial, 68 cases of SVT and 86 cases of AF-FVR were studied. Patients with evidence of renal dysfunction and systolic blood pressure less then 90 mm Hg were excluded. Response was considered when the heart rate fell to less than 100/min. In SVT, 33.3% (11 out of 33) responded to magnesium sulphate which was significantly less than verapamil (23 out of 35, 65.7%) p = 0.007. Similarly, in AF-FVR, response was more with verapamil (25 out of 45, 55.6%) than magnesium sulphate (8 out of 41, 19.5%) p < 0.0001. Response to magnesium sulphate was better in patients with IHD. There were no significant side effects, except flushing and sense of warmth with i.v. magnesium sulphate. Serum magnesium rose significantly after i.v. magnesium bolus. Though magnesium sulphate is a weaker antiarrhythmic drug than verapamil, further studies are needed to identify subgroups of supraventricular tachyarrhythmias which would respond to magnesium sulphate.
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PMID:Efficacy of intravenous magnesium sulphate in supraventricular tachyarrhythmias. 877 69

Nitrogen (N2) may accumulate to unacceptable levels during closed-circuit anesthesia (CCA) when the sampled gases are redirected to the anesthesia circuit, because many gas analyzers entrain air as a reference gas to calibrate for oxygen analysis. Using oxygen instead of air as the reference gas for paramagnetic oxygen analysis could attenuate N2 accumulation. Forty-three adult ASA physical status I-III patients undergoing a variety of peripheral and abdominal procedures were assigned to one of two groups, depending on the reference gas used by a paramagnetic oxygen analyzer, either air (group I, n = 23) or oxygen (group II, n = 20). Gases sampled by the multigas analyzer were redirected to the anesthesia circuit. End-expired N2 (N2Et) was calculated as "balance gas": (100 - %O2 - %anesthetic vapor - %CO2). N2Et after 55 min (N2Et55min) was correlated with the end-expired N2 concentration when the circuit was closed (N2Et0min) and 5 min (N2Et5min) thereafter. In group I, N2Et accumulated almost linearly over time (t, min): N2Et (%) = 2.47 + 0.61 * t (r2 = 0.999). N2Et0min, N2Et5min, and N2Et55min were 1.3+/-0.8, 5.3+/-1.7, and 35.3+/-5.3%, respectively (mean +/- SD). The correlation (r2) between N2Et55min and N2Et0min was 0.19, and between N2Et55min and N2Et5min it was 0.56. In group II, N2Et increased exponentially: N2Et (%) = 1.01 + 11.9 * (1 - e(-t/43.5)) (r2 = 0.99). N2Et0min, N2Et5min, and N2Et55min were 0.87+/-0.93, 2.6+/-1.5, and 10.1+/-2.9%, respectively. The correlation (r2) between N2Et55min and N2Et0min was 0.04, and between N2Et55min and N2Et5min it was 0.40. We conclude that paramagnetic oxygen analyzers that use oxygen as the reference gas significantly attenuate N2 accumulation during CCA, which may reduce the need for frequent flushing of the anesthesia system, may provide more constant oxygen and nitrous oxide concentrations, and may simplify pharmacokinetic studies of potent inhaled anesthetics.
J Clin Monit Comput 1998 Aug
PMID:Influence of the reference gas of paramagnetic oxygen analyzers on nitrogen concentrations during closed-circuit anesthesia. 1002 34

Pharmacokinetics of intravenous and oral pulsed high-dose dexamethasone were studied in four patients with pemphigus vulgaris. Doses for dexamethasone were varied from 100 to 300 mg. Serum concentrations were measured by high-performance liquid chromatographic procedure with diode assay detection. Bioavailability was assessed by comparing the areas under the serum concentration-time curves following oral administration with those of intravenous administration. Mean bioavailability of high-dose oral dexamethasone was 63.4%. Side effects were minor and were limited to temporary facial flushing both after oral and intravenous administration. Oral administration of dexamethasone in pemphigus patients showed to be more convenient and cost effective than administration by the intravenous route.
Ther Drug Monit 1999 Oct
PMID:Pharmacokinetics of high-dose oral and intravenous dexamethasone. 1051 50

A soil that had been historically contaminated with Aroclor 1242, 1248, 1254 and 1260 was decontaminated by two surfactant-mediated cleaning procedures that had been chosen to mimic ex-situ washing and in-situ soil flushing processes. A preliminary screening selected four surfactants (from 17 commercial formulations) for their ability to mobilise PCBs from the soil while suffering minimal losses to the supercritical carbon dioxide (scCO2) that was used in a separate back-extraction procedure. The mobilisation was enhanced, with minimal foam formation, by the presence of 17% (v/v) IBMK in the surfactant suspension. Each of the four surfactants, at 1, 3, or 5% (v/v) concentration, was evaluated by (i) 15 successive 10 min sonication-filtrations and (ii) continuous soil column flushing during 20 h. Each filtrate from (i) and samples, taken at hourly intervals, from (ii) were analysed for their PCB and surfactant content. Both extraction procedures mobilised PCBs efficiently when extended for longer periods and were modelled accurately as the sum of a constant and single-term exponential increase to a maximum. The predicted number of replicate stages required to mobilise 50% of the toxicants (t50) varied from 7 to 3 for sonication-washing of the soil (10 g) or from 6.8 to 2.8 h for column flushing of 30 g soil and decreased as the concentration of surfactant in the aqueous phase was increased. The combined PCB-laden aqueous suspensions were then back-extracted efficiently with scCO2 and the eluate was dechlorinated quantitatively as it traversed a short, heated column of silver-iron bimetallic mixture.
J Environ Monit 2001 Jun
PMID:Approaches to the remediation of a polychlorinated biphenyl (PCB) contaminated soil--a laboratory study. 1143 64

In order to assess the applicability of an earthworm bioassay as a technique for monitoring the soil flushing process, short-term and long-term toxicity tests were conducted on remediated soil using various pore volumes of surfactant solution. Results obtained on short-term toxicity testing indicated that biomass increased as the soil flushing proceeded, and on diesel-contaminated soils this testing showed that the effect of diesel is lethal and that 25 pore volumes of soil surfactant were not sufficient to abrogate the toxic effect of diesel. These short-term tests also showed strong sublethal relationships between the development of biomass, and the concentrations of toxic chemicals in the soil. Although relationships between contaminants and the various bioassay parameters examined were not significant in long-term testing, an increase in the number of juveniles was observed over time, which may have been a consequence of a reduction in toxicity associated with the flushing process.
Environ Monit Assess 2001 Jul
PMID:Ecotoxicity monitoring of hydrocarbon-contaminated soil using earthworm (Eisenia foetida). 1151 24

Quantifying chemical variability in different lake types is important for the assessment of both chemical and biological responses to environmental change. For monitoring programs that emphasize a large number of lakes at the expense of frequent samples, high variability may influence how representative single samples are of the average conditions of individual lakes. Intensive temporal data from long-term research sites provide a unique opportunity to assess chemical variability in lakes with different characteristics. We compared the intra- and inter-annual variability of four acidification related variables (Gran alkalinity, pH, sulphate concentration, and total base cation concentration) in four lakes with different flushing rates and acid deposition histories. Variability was highest in lakes with high flushing rates and was not influenced by historic acid deposition in our study lakes. This has implications for the amount of effort required in monitoring programs. Lakes with high flushing rates will require more frequent sampling intervals than lakes with low flushing rates. Consideration of specific lake types should be included in the design of monitoring programs.
Environ Monit Assess
PMID:Inter- and intra-annual chemical variability during the ice-free season in lakes with different flushing rates and acid deposition histories. 1457 Apr 9

Vassova lagoon is a typical Mediterranean (small, shallow, micro-tidal, well-mixed) coastal lagoon, receiving limited seasonal freshwater inflows from direct precipitation and underground seepage. An intensive study was carried out in order to quantify the mechanisms responsible for the intra-tidal and residual transport of water, salt, nutrients and chlorophyll at the mouth of this lagoon and to assess the lagoon's flushing behavior. Results indicated that although the system is micro-tidal, tidal effects appeared to be the dominant factor for the longitudinal distribution of physical and chemical parameters, while the associated residual flow is also important and serves as a baseline measure of overall circulation. However, analysis of the net longitudinal currents and fluxes of water, salt and nutrients revealed the importance of non-tidal effects (wind effect and precipitation incidents) in the mean tidal transport. It is shown that the Eulerian residual currents transported water and its properties inwards under southern winds, while a seaward transport was induced during precipitation incidents and northern winds. The Stokes drift effect was found an order of magnitude lower than the Eulerian current, directed towards the lagoon, proving the partially-progressive nature of the tide. Nutrients and chlorophyll-alpha loads are exported from the lagoon to the open sea during the ebb phase of the autumn and winter tidal cycles, associated with the inflow of nutrient-rich freshwater, seeped through the surrounding drainage canal. The reverse transport occurs in spring and early summer, when nutrients enter the lagoon during the flood tidal phase, from the nutrient-rich upper layer of the stratified adjacent sea. Application of a tidal prism model shows that Vassova lagoon has a mean flushing time of 7.5 days, ranging between 4 to 18 days, affected inversely by the tidal oscillation.
Environ Monit Assess 2006 Aug
PMID:Quantification of water, salt and nutrient exchange processes at the mouth of a Mediterranean coastal lagoon. 1674 22


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