Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is reported of a 96-year-old woman with congestive heart failure, hypertension, and chronic obstructive pulmonary disease who presented with altered mental status and severe hyperkalemia, a serum potassium 9.3 meq/L, and electrocardiograph changes. The patient was discharged 1 week prior, with a normal serum potassium, receiving trimethoprim-sulfamethoxazole for urinary tract infection and pneumonia. Serum potassium measurements returned to normal after discontinuation of the drug. Other causes of hyperkalemia were ruled out. Mild hyperkalemia due to trimethoprim-sulfamethoxazole was first reported in 1983 in a 69-year-old woman in whom leukemia with leukopenia developed. In literature to date, mild hyperkalemia in younger geriatric patients has been described. Trimethoprim is thought to act by inhibiting amiloride sensitive sodium channels in the distal nephron and impairing renal potassium secretion in a dose dependent manner. The authors report the case, review the literature, and discuss age-related reduction in renal function as a possible etiology.
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PMID:Case report: severe hyperkalemia in a geriatric patient receiving standard doses of trimethoprim-sulfamethoxazole. 861 80

Twenty-three neutropenic patients with haematological malignancies and febrile pulmonary infiltrates were empirically treated with liposomal amphotericin B (AmBisome) in addition to broad-spectrum antibiotics. AmBisome was given on alternate days in two different dosages: 3 mg kg-1 in patients with pneumonia but without radiological signs or other evidence of Aspergillus infection and 5 mg kg-1 in pneumonia patients with suspected Aspergillus infection. The main objectives of this study were to compare the response and lethality of pneumonias treated early with empirically AmBisome with a historical group (treatment with conventional amphotericin B only in case of proven/highly probable aspergillosis) and to investigate the tolerability and efficacy of AmBisome 5 mg kg-1 in cases of proven/probable aspergilloses. Six out of seven (86%) patients without initially suspected aspergilloses receiving AmBisome 3 mg kg-1 responded completely. Twelve out of 16 patients with initial radiological signs of aspergillosis receiving AmBisome 5 mg kg-1 were evaluable. Body temperature normalized in 10/12 (83%) patients; eight experienced complete and two partial regression of their infiltrations and 9/10 patients with proven/probable aspergillosis responded. Acute AmBisome-related reactions were seen in three patients from each group; loss of potassium was noted in five subjects in each group and slightly increased plasma creatinine was found in two patients in the 5 mg kg-1 group. Altogether, the response of all pneumonia patients treated with early empirical AmBisome compared with the historical group was 17/19 vs. 49/72 (89% vs. 68%, NS); among those with proven/probable aspergilloses 11/12 vs. 7/17 (92% vs. 41%, P = 0.008) patients responded. Pneumonia lethality was 1/19 in the AmBisome-treated patients compared with 23/72 in the historical group (5% vs. 32%, P = 0.01); and among those with proven/probable aspergilloses it was 1/12 vs. 10/17 (8% vs. 59%, P = 0.008). In conclusion, early empiric treatment with AmBisome 3 mg kg-1 and 5 mg kg-1 on alternate days was well tolerated and greatly reduced the lethality of proven/probable Aspergillus pneumonias.
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PMID:Liposomal amphotericin B as early empiric antimycotic therapy of pneumonia in granulocytopenic patients. 914 97

Step-by-step therapy of patients with pneumonia and exacerbated chronic bronchitis with amoxyclav (amoxycillin/potassium clavulanate) in a dose of 1.2 g administered intravenously dropwise every 8 hours for the first 2 days of the treatment with subsequent oral use of the drug in a dose of 625 mg thrice a day for 5 days proved to be highly efficient. The recovery and improvement were stated in 19 (95 per cent) out of 20 patients. The adverse reaction (urticaria) was observed in 1 patient. Identical results were recorded in a comparative randomized trial with the use of cefotaxime in a dose of 1.0 g intramuscularly every 8 hours for 7 days. The pharmacoeconomic estimate showed the expediency of the step-by-step therapy with the use of amoxycillin/potassium clavulanate.
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PMID:[Amoxycillin/potassium clavulanate in inpatients with bronchopulmonary infections]. 941 97

Amoxyclav (amoxycillin/potassium clavulanate, A/PC) was used in a dose of 625 mg 3 times a day in the treatment of 68 outpatients at the age of 17 to 88 years (the average age of 49 years) with slight or moderate community-acquired pneumonia. In 49 per cent of the patients the pneumonia developed at the background of concomitant chronic diseases. The positive clinical effect was observed in 94 per cent of the patients. In 76 per cent of them a short-term treatment course of 5 days was sufficient. Before the treatment 91.8 per cent of the isolates proved to be susceptible to A/PC. The pathogen eradication after completion of the treatment was stated in 72 per cent of the cases. Moderate gastrointestinal adverse reactions developed in 4 patients (6 per cent). The results demonstrated high clinical and bacteriological efficacies of A/PC and made it possible to recommend the drug as the 1st class agent for the initial empirical therapy of community-acquired pneumonia in outpatients.
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PMID:[Coamoxiclav in the empirical monotherapy in outpatients with community acquired pneumonia]. 941 98

Amoxyclav (amoxycillin/potassium clavulanate, A/PC) was used in the treatment of 55 children with acute bronchitis and pneumonia. The drug was administered in a dose of 20-40 mg/kg body weight a day in 3 portions. The treatment course was 4 to 10 days. The treatment was performed under careful clinicoroent-genologic control. The clinical picture of the disease in the children was characterized by a moderate process which made it possible to treat the children as outpatients. The clinical efficacy amounted to 90.5 per cent. The isolates of Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophilus influenzae proved to be susceptible to A/PC. It may be used as the 1st class agent in the treatment of children with lower respiratory tract infection.
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PMID:[Efficacy and tolerance of coamoxiclav in community-acquired lower respiratory tract infections in children]. 941

Pasteurella multocida is a bacterial pathogen that causes rhinitis (snuffles), pneumonia, otitis media, septicemia, metritis, and death in domestic rabbits. Currently, there are no effective vaccines to prevent infection by this organism. Subcutaneous (s.c.) immunization with either exotoxin or thiocyanate extracts of P. multocida induces partial protection in rabbits. Since disease begins at mucosal sites, induction of local immunity may be important in preventing systemic disease. Little is known concerning the efficacy of intranasal (i.n. ) administration of these antigens in inducing protective mucosal immunity to P. multocida in rabbits. The purpose of this study was twofold: (i) to investigate the effectiveness of vaccination with purified P. multocida toxin (PMT) and a potassium thiocyanate extract of P. multocida (CN) in combination and (ii) to evaluate the efficacy of administration of these antigens i.n. versus s.c. Forty-eight rabbits were randomly divided into eight different treatment groups. Rabbits received either one or both antigens by either s.c. or i.n. administration. Following vaccination, each group received an i.n. challenge of P. multocida. Rabbits vaccinated with both antigens i.n. or s.c. had a 100% survival rate, few or no bacteria in the liver and lungs, high serum immunoglobulin G (IgG) and IgM antibody titers, and significant numbers of IgG antibody-secreting cells (ASC) in the spleen and tracheobronchial lymph node. Rabbits vaccinated i.n. had significant nasal and bronchoalveolar lavage IgA antibody levels. Rabbits vaccinated with only one antigen, either PMT or CN, had lower antibody titers, moderate to severe liver and lung infections, and fewer ASC compared to rabbits receiving both antigens. Rabbits in the control groups had moderate to severe liver and lung infections. This study indicates that i.n. immunization with both PMT and CN induces an effective response against homologous P. multocida challenge.
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PMID:Induction of protective immunity in rabbits by coadministration of inactivated Pasteurella multocida toxin and potassium thiocyanate extract. 967 63

The epidemiology, resistance mechanisms, susceptibility testing, treatment, prevention, and clinical importance of penicillin-resistant Streptococcus pneumoniae (PRSP) infection are discussed. PRSP is an established presence in the United States, with some geographic areas reporting decreased susceptibility in up to half of isolates. The mechanism of resistance to beta-lactam antibiotics in S. pneumoniae is genetic changes resulting in decreased binding of drug to the bacterial cell wall. Emerging PRSP strains have necessitated testing as a tool in selecting drugs for treating life-threatening infections. Opinions differ on how to treat these infections empirically. Non-life-threatening infections, such as otitis media, are still often treated successfully with amoxicillin, amoxicillin-clavulanate potassium, or a third-generation cephalosporin. Currently recommended initial treatment of pneumococcal pneumonia in otherwise healthy patients requiring hospitalization consists of cefuroxime, ceftriaxone, or cefotaxime; some authors continue to emphasize injectable penicillin. Once the mainstay of empirical treatment of pneumococcal meningitis, penicillin has largely been abandoned in favor of cefotaxime or ceftriaxone. Vaccination remains an underutilized strategy in atrisk populations. The clinical importance of penicillin resistance among pneumococci is still uncertain. Changing patterns in the susceptibility of S. pneumoniae to penicillin make selection of appropriate therapy increasingly difficult. Key considerations are the site of infection and the level of resistance.
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PMID:Strategies in the treatment of penicillin-resistant Streptococcus pneumoniae. 978 85

The purpose of this study was to determine the effects of aminoguanidine (AG) and meclofenamate (MEC) on depressed contractility of small pulmonary artery (PA) rings isolated from a rat model of acute Pseudomonas pneumonia. Contractility of PA rings from lungs of control or pneumonia rats was assessed in vitro by obtaining cumulative concentration-contraction curves to potassium chloride (KCl), phenylephrine (PE), and prostaglandin F2alpha (PGF2alpha) on rings treated with or without MEC (1.0 microM), AG (100 microM), or AG + MEC. Vessels from pneumonia rats exhibited significant attenuation of the contractile responses to KCl, PE, and PGF2alpha. MEC restored the KCl and PGF2alpha contractile responses to control values, but had no effect on the attenuated PE contractile response. In contrast, AG restored the PE contractile response, and only partially affected contractile responses to KCl and PGF2alpha, MEC + AG restored the contractile responses of all three agonists. We conclude that both excess nitric oxide (NO) and cyclooxygenase products contribute to the depressed pulmonary vascular contractility observed in rats with acute pneumonia. The relative importance of NO and cyclooxygenase products in this phenomenon depends on the contractile agonist studied.
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PMID:Pulmonary artery contractility in pneumonia: role of cyclooxygenase products and nitric oxide. 1047 Oct 9

The case of a 74-year-old woman with past history of hypertension and cerebrovascular accident admitted with pneumonia, dehydration, hypernatremia and severe hypokalemic alkalosis is presented. After correction of the hypertonic dehydration, the hypokalemia and alkalosis persisted in spite of aggressive potassium supplementation and the patient became hypertensive. Mineralocorticoid excess was suspected and excluded after extensive endocrinological testing. The use of aldactone failed to revert the abnormalities. Triamterene administration corrected the electrolytes and acid base aberrations, and dramatically improved the blood pressure control. This clinical picture is compatible with the diagnosis of Liddle's syndrome. Our patient exemplifies the unique occurrence of hypokalemic metabolic alkalosis in association with volume contraction at the start of the hospitalization and volume expansion later on her course.
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PMID:Saline-resistant metabolic alkalosis, severe hypokalemia and hypertension in a 74-year-old woman. 1066 85

Community-acquired bacterial respiratory tract infections are among the most common health disorders requiring medical care and are associated with substantial morbidity, mortality, and direct and indirect costs. Recent increases in the prevalence of antimicrobial resistance have resulted in reduced susceptibility of the most common respiratory tract bacterial pathogens to a number of antimicrobials. Amoxicillin/clavulanate potassium extended release (ER) tablets (Augmentin XR, GlaxoSmithKline) is a new formulation of amoxicillin/clavulanate that retains activity against betalactamase-producing organisms whilst increasing the activity against Streptococcus pneumoniae through elevated and sustained plasma amoxicillin concentrations. The bilayer tablet provides immediate release of clavulanate and both immediate and sustained release of amoxicillin to maintain therapeutic concentrations of amoxicillin over longer periods of the dosing interval. In clinical trials of acute bacterial sinusitis (ABS) and community-acquired pneumonia (CAP), amoxicillin/clavulanate ER was shown to have excellent bacteriological and clinical success rates, even in patients infected with antimicrobial-resistant pathogens, and was found to be generally well tolerated. Amoxicillin/clavulanate ER is approved in the US for the treatment of patients with ABS or CAP caused by beta-lactamase-producing pathogens (ie, Haemophilus influenzae, Moraxella catarrhalis, Haemophilus parainfluenzae, Klebsiella pneumoniae, or methicillin-susceptible Staphylococcus aureus) and S. pneumoniae with reduced susceptibility to penicillin (penicillin minimum inhibitory concentration = 2.0 microg/ml).
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PMID:Amoxicillin/clavulanate potassium extended release tablets: a new antimicrobial for the treatment of acute bacterial sinusitis and community-acquired pneumonia. 1452 93


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