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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of tolamolol, a cardioselective beta adrenergic blocking agent, was evaluated in the treatment of cardiac arrhythmias in 27 patients. Nineteen patients had supraventricular arrhythmias and eight had ventricular arrhythmias. Evaluation was by doulbe-blind randomized trial in 23 patients. Tolamolol was effective in reducing ventricular rate in 17 (85 percent) of 19 patients with supraventricular arrhythmias and resulted in conversion to sinus rhythm in 2 of the 17. The mean ventricular rate in 17 patients decreased from 135 to 102/min 10 minutes after initiation of administration of tolamolol and gradually decreased further to 93/min after 60 minutes. Reduction in ventricular rate was sustained for 2 hours of monitoring undergone by all patients and for 4 and 6 hours monitoring in two subgroups. Among the eight patients with ventricular ectopic beats, tolamolol reduced their frequency in four patients and had no effect in four. Six patients had chronic obstructive pulmonary disease and experienced no adverse clinical effects on respiratory function in association with administration to tolamolol. Untoward effects occurred in 10 patients, including hypotension in 3, 1 of whom required vasopressor therapy. Other side effects were sedation, nausea, dyspnea and warmth in the chest, all of which were mild and transient, requiring no treatment. Cardioselective beta adrenergic blockade with tolamolol was highly effective in controlling ventricular rate in supraventricular arrhythmias and reduced the frequency of ventricular ectopic beats in half of the small group of patients with this arrhythmia. It is particularly applicable in patients with obstructive pulmonary disease in whom cardiac beta adrenergic blockade is indicated. Hypotension is an important potential side effect.
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PMID:Efficacy of cardioselective beta adrenergic blockade with intravenously administered tolamolol in the treatment of cardiac arrhythmias. 0 52

A double-blind multicenter study was carried out to evaluate the effectiveness of ambroxol, a drug able to promote surfactant synthesis, in the prevention of postoperative bronchopulmonary complications. A total of 252 patients with chronic obstructive lung disease (COLD) undergoing upper abdominal surgery were randomly allocated to receive either 1 g/day of ambroxol intravenously for 6 consecutive days in the perioperative period or placebo. Pulmonary complications were evaluated by clinical studies, radiographic, and blood gas analysis. There was a significant difference in atelectasis between the 2 groups (10.6% ambroxol vs 23.9% placebo). In addition, analysis of variance showed that the PaO2 values of the ambroxol-treated group after surgery decreased less than those of the placebo-treated group (p less than 0.05) from the preoperative values. The treatment was well tolerated, although nausea was significantly more frequent in the ambroxol-treated group. We think that ambroxol should be considered as an alternative and new pharmacologic approach for the prevention of postoperative pulmonary complications.
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PMID:Prevention by ambroxol of bronchopulmonary complications after upper abdominal surgery: double-blind Italian multicenter clinical study versus placebo. 168 56

Fifty-one patients with chronic obstructive lung disease with a proven bacterial respiratory tract infection were treated with ciprofloxacin 500 mg twice daily or 750 mg twice daily. Both dosages were given orally for approximately 10 days. The higher dosage showed a reduced amount of reinfections and relapses (19% and 16% versus 5% and 0%). The overall results were the same in both groups. Adverse reactions were mild: nausea and visual disturbances were seen in five patients. Eight patients had slight liver test abnormalities. In one patient a seizure occurred. All adverse reactions were of a temporary nature.
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PMID:Two different dosages of ciprofloxacin in patients with respiratory tract infections. 279 36

A 55-year-old woman with common variable immunodeficiency and mild chronic obstructive lung disease received 3 units of plasma as immunoglobulin replacement therapy. During the administration of the final unit, her temperature rose 1 degree C, with no other observable symptoms. Fifteen minutes later she developed shortness of breath without nausea, vomiting, rash, or pruritus. In 30 min she lost consciousness, was breathless, and cyanotic. Resuscitative efforts failed. Autopsy failed to pinpoint a cause of death. There was no evidence of ABO or Rh incompatibility, bacterial contamination, or hemolysis. There were no neutrophil, platelet or IgA antibodies detectable in the patient or the 3 plasma donors. There were no lymphocytotoxic HLA antibodies in the patient or two of the plasma donors. The third donor had HLA-B35 lymphocytotoxic antibodies that did not agglutinate or aggregate neutrophils. The patient's HLA type was A2, A3; B35, B40. Lymphocytotoxic crossmatches using lymphocytes of the patient were positive with plasma from the third donor but negative with the other two. An eluate prepared from post-mortem lung parenchymal tissue was cytotoxic to 7 of 8 panel lymphocytes positive for the HLA-B35 antigen but not with cells lacking B35. The implicated plasma donor was healthy with a history of 6 pregnancies. This case report illustrates the potential hazard of transfusion of plasma containing HLA antibodies.
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PMID:Fatal pulmonary transfusion reaction to plasma containing donor HLA antibody. 280 Apr 69

The chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of ipratropium bromide are reviewed. Ipratropium bromide, a synthetic quaternary isopropyl derivative of atropine, interrupts vagally mediated bronchoconstriction by inhibiting the cyclic guanosine 3',5'-monophosphate system at parasympathetic nerve endings. Ipratropium bromide is poorly absorbed after oral and inhaled administration but diffuses rapidly into tissue after i.v. or i.m. administration. The elimination half-life is 3.2-3.8 hours. After inhalation, the drug is eliminated in the urine and feces. The bronchodilatory effect of ipratropium bromide in stable chronic obstructive pulmonary disease appears to be comparable, and may be superior, to that of the beta-sympathomimetic agents. In acute exacerbations, ipratropium bromide is useful but may not be the preferred agent because of a delayed onset of action (within 15 minutes; mean dose-dependent duration of effect, three to five hours). Combination therapy with other bronchodilating drugs has proved useful. Ipratropium bromide may be a useful adjunctive agent in the treatment of asthma. Since the onset of action is delayed, ipratropium bromide should not be used as single-drug therapy in an acute asthmatic exacerbation. Reported adverse effects, including cough, nausea, palpitations, dry mouth, nervousness, gastrointestinal distress, and dizziness, have been mild. The usual dosage is two inhalations (36 micrograms) four times daily, and the maximum number of doses per day should not exceed 12. Although ipratropium bromide is currently indicated only for maintenance therapy in stable chronic bronchitis and emphysema, it may be useful as adjunctive therapy in asthma and in the management of acute exacerbations of chronic bronchitis and asthma. Additional experience in a variety of chronic obstructive pulmonary disorders will help to clarify the role of ipratropium bromide in the treatment of obstructive pulmonary disease.
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PMID:Use of ipratropium bromide in obstructive lung disease. 297 9

Almitrine bismesylate is a chemoreceptor agonist which has been shown to improve arterial blood gas values in chronic obstructive pulmonary disease (COPD) patients, possibly through better ventilation/perfusion matching. On these basis, long term studies were undertaken to evaluate the therapeutic activity of almitrine bismesylate in COPD. We report here the overall results of 4 studies: a 6 months double blind placebo controlled study on clinical and biochemical data in 200 patients. a 12 months double blind placebo controlled study on clinical and hemodynamic data in 15 patients. a 12 months open study on clinical and biochemical data in 108 patients. a 52 months follow-up including therapeutic gap in 8 patients. Almitrine bismesylate group showed significant improvement of PaO2 and PaCO2 levels as compared with placebo group; this was found after 6 months of treatment and persisted after 12 months of treatment. 75% of almitrine treated patients were considered as responders, i.e. improved PaO2 and PaCO2 levels by at least 5 mmHg (0.665 KPa). Almitrine bismesylate groups showed significantly decreased dyspnea scores, received significantly less hospital care for acute decompensation or pulmonary infection and showed no significant change in hemodynamic parameters. After 20 months treatment interruption, patients showed progressively impairmed blood gas levels. Almitrine bismesylate ws well tolerated; nausea was occasionally observed and usually disappeared. Paresthesia was observed in some patients with identified predisposition. Altogether, these studies showed long term efficacy and acceptability of almitrine bismesylate in COPD patients with chronic respiratory failure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long term studies on almitrine bismesylate in COPD patients. 309 67

A double-blind cross-over study was undertaken to compare the efficacy of amoxycillin and pivampicillin on Haemophilus influenzae infection of the lower respiratory tract in children. 20 patients with cystic fibrosis (CF) or chronic obstructive pulmonary disease (COPD) due to other causes were included in the study. All patients had a history of regularly harbouring H. influenzae in sputum and repeated treatment failures with pivampicillin. 18 completed two 14-day courses in random order with equimolar doses of pivampicillin (80 mg/kg/day) and amoxycillin (62 mg/kg/day). Both drugs were well tolerated with no serious side effects, but pivampicillin was associated with more pronounced nausea. In steady state the mean serum concentrations of antibiotics 2 and 4 h after medication were 9.7 and 3.7 micrograms/ml for pivampicillin and 19.1 and 7.9 micrograms/ml for amoxycillin (p less than 0.01). Eradication of H. influenzae and clinical improvement was seen in one-third of the courses with both drugs. Betalactamase producing ampicillin-resistant strains emerged during 58% of the amoxycillin courses, but only in 16% of the pivampicillin courses (p less than 0.001). The high number of treatment failures and the development of resistant strains indicate that betalactamase inhibitors may possibly improve the efficacy of these drugs, especially of amoxycillin, in these patients.
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PMID:A comparative study of amoxycillin and pivampicillin in persistent Haemophilus influenzae infection of the lower respiratory tract in children with chronic lung disease. 352 32

During a 2 year period nitrous oxide was used as a sole or supplementary analgesic during 173 vascular or interventional procedures including peripheral angiography and endourologic and endobiliary procedures. The decision to administer nitrous oxide to a given patient was a matter of physician preference. Patients with bowel obstruction, pneumothorax, or chronic obstructive pulmonary disease were excluded from this method of analgesia. The nitrous oxide was administered by a radiology nurse under the supervision of an attending radiologist. Nitrous oxide was used without premedication for 39 procedures and with premedication (usually meperidine 1 mg/kg, promethazine 0.3 mg/kg, or atropine 0.01 mg/kg) in 134 procedures. In 74% of nonpremedicated individuals analgesia was adequate with nitrous oxide alone; 26% required supplemental intravenous medication. In 61% of premedicated individuals pain relief was adequate with nitrous oxide; 39% required supplemental intravenous medication. Complications, including nausea, vomiting, and agitation, occurred in eight patients, but were minor and easily reversed by decreasing the concentration of nitrous oxide. Nasally administered nitrous oxide is a safe, easily used, and effective analgesic.
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PMID:Nitrous oxide: effective analgesic for vascular and interventional procedures. 387 37

Pharmacokinetics and ventilatory response to Theodur (Th) was compared to that of Aminomal R (AR) in a randomized within-patient double-blind study, carried out in patients with chronic obstructive lung disease. Both slow-release preparations of theophylline were given every 12 hours for 14 days each at the end of a placebo wash-out period. Th and AR did not differ significantly in their bronchodilating effect at 3 and 12 hours after intake. Salbutamol consumption was not dissimilar in the 2 preparations. Mean serum theophylline levels remained within the therapeutic range at 2, 3 and 12 hours after sustained administration of both Th and AR, but were slightly lower and less fluctuating after Th. Gastrointestinal side effects such as epigastric discomfort, nausea, abdominal pain and diarrhea were more common after AR, a result likely due to its higher content of anhydrous theophylline per tablet (474 mg vs 300 mg in Th). In conclusion, we failed to detect differences between Th and AR in their bronchodilating effect after sustained treatment in patients with chronic obstructive lung disease. Th, however, although containing less theophylline per tablet, resulted in comparable theophylline levels with similar ventilatory response, in presence of a better gastrointestinal tolerability. These results suggest a better bioavailability of Th, likely accounted for by a more advanced pharmaceutical technology.
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PMID:Serum theophylline and ventilatory function in chronic obstructive lung disease. Comparison between two slow-release formulations of theophylline. 390 30

Over the last 2 years we have applied a therapeutic regimen with simultaneous use of cephalexin and bromhexine in therapy for infective exacerbations of COLD patients. The results obtained are positive. Bacteriologic features, the modification of sputum and, where possible, behavior of hematologic parameters and blood gases were checked. This pharmacologic combination appears to be useful in pneumology, as it yields very good results in obstructive chronic bronchitis in a bacterial relapsing phase and with alveolar hypoventilation linked to massive presence of endoluminal mucus. With the exception of two patients, in whom nausea and gastric pyrosis were observed, we observed no toxic or side effects of any kind, not even in subjects treated for a long time.
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PMID:Therapy for intercurrent respiratory infections in COLD patients: report on 200 patients. 686 31


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