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 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diprafenone is a new antiarrhythmic drug with a dominant local anaesthetic action and an additional beta-sympathicolytic activity. In this study, the results of long-term treatment (8 months on average) obtained from 27 patients with chronic ventricular arrhythmias are reported. Before diprafenone, all patients were treated unsuccessfully with flecainide, propafenone, sotalol, combined sotalol/flecainide and sotalol/propafenone, and another two to six antiarrhythmic agents. Following diprafenone (300-600 mg/24 h), a substantial reduction in arrhythmic activity (greater than or equal to 80%; Lown classification less than or equal to II) was achieved in 21 cases. In 12 patients, side effects (fatigue, headache, blurred vision, dizziness and heartburn) were apparent. Diprafenone had to be discontinued in five patients, because of these side effects. At dosages greater than or equal to 450 mg/24 h, the PQ interval was significantly lengthened, and QRS duration prolonged. In one patient, an AV block III degree developed. In another case, SGOT and SGPT increased significantly; this increase was reversed after the drug was discontinued. Despite these side effects, further clinical evaluation of the compound seems promising, as the antiarrhythmic potency of diprafenone is very strong and superior to that of propafenone with respect to the required doses.
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PMID:[Treatment of chronic ventricular arrhythmias with the new class Ic anti-arrhythmia agent diprafenon--results of long-term therapy]. 367 63

Fifteen patients with ventricular premature complexes (VPCs) were included in this open study designed to assess the relative efficacy of bid (two times daily) and tid (three times daily) dosing regimens for cibenzoline as compared with qid (four times daily) administration. Patients started therapy with qid administration; this was followed in sequence by tid and bid administration at the maximum effective total daily dose determined during the qid administration. Of the nine patients evaluated for efficacy for suppression of VPCs, eight demonstrated a 75% or greater suppression of VPCs with cibenzoline administered qid (total daily dose of 130-325 mg). This effectiveness was maintained in four patients with a bid regimen and in three with a tid regimen. All four patients who had ventricular tachycardia (VT) had a decrease in the number of VT episodes while receiving cibenzoline (only one of these patients had satisfactory suppression of VPCs at the same dosage regimen). Twelve patients continued to receive extended therapy with cibenzoline for up to two years, as this was considered to be the optimum antiarrhythmic treatment for these patients. Two patients had to be removed from the study and two had the dosage lowered because of adverse reactions (dry mouth, blurred vision, dizziness, congestive heart failure) although in one instance, the congestive heart failure was subsequently considered to be unrelated to cibenzoline. One patient was able to complete the short-term phase of the trial, but was not given extended treatment because of persistent dry mouth. Two patients had treatment discontinued during the extended therapy phase because of adverse reactions (fever, nausea, vomiting, asthenia).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of dosing interval and optimum dose of cibenzoline. 368 May 96

Isobutyl nitrite is a volatile liquid sold without a prescription as a "room odorizer" but is widely used as an inhalant to produce feelings of euphoria. Of the 173 13-22-year-olds (mean age, 16 years) clients of a long-term drug treatment facility who completed a questionnaire related to drug use, 74 (43%) admitted to having used isobutyl nitrite at least once, 22 (13%) had used the substance ten or more times, and eight (4%) used the substance 50 or more times. Inhalation of this malodorous substance leads almost universally to dizziness and lightheadedness and usually to severe symptoms of vasodilatation such as "pounding of the heart," blurred vision, and a "warm feeling." The feeling was unpleasant to 44 percent of the users in this study, and most also experienced pulsatile headache. In addition, contact dermatitis and irritation of the tracheobronchial tree and eyes occurred in some users. The primary use of this substance as an euphoric agent warrants consideration of banning its sale altogether.
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PMID:Abuse of isobutyl nitrite inhalation (Rush) by adolescents. 369 54

Flecainide acetate is a new orally active antidysrhythmic agent classified in the Ic category. Flecainide is effective in suppressing 88 to 100 percent of abnormal cardiac rhythms in the form of complex ventricular dysrhythmias, including couplets, ventricular tachycardia, reentrant junctional tachycardia, and Wolff-Parkinson-White syndrome. Flecainide appears to have a greater effect on conduction than on repolarization and only minimal effects on hemodynamic parameters. Flecainide is rapidly and completely absorbed after oral administration and has a 13-hour elimination half-life, allowing for twice-daily dosing regimens. Flecainide is generally well tolerated, with dizziness, blurred vision, nausea, and headache the most common side effects. Flecainide has been shown to be superior to quinidine and disopyramide in suppressing ventricular ectopic activity and may be considered a first-line oral agent for this indication. It is believe that flecainide has enough therapeutic advantages to be added to drug formularies.
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PMID:Flecainide: a new class Ic antidysrhythmic. 390 29

A hypertensive urgency should be distinguished from a hypertensive emergency. Although the distinction may not always be obvious, certain guidelines may help the clinician determine which therapeutic approaches are most appropriate for each patient. Hypertensive emergencies include those conditions in which new or progressive severe end-organ damage is present and a delay in appropriate therapy might result in permanent damage, progression of complications, and a poor prognosis. Hypertensive urgencies include those conditions with minimal to no obvious end-organ damage in which blood pressure should be lowered expeditiously. The risk of immediate complications or organ damage is less likely to occur, and thus the immediate prognosis is better, although the ultimate prognosis, if untreated, is poor. There is a marked individual, racial, sexual, and age difference in the ability to tolerate high intraarterial pressure, as evidenced by patients' symptoms and signs of end-organ damage. Patients may have no symptoms of elevated blood pressure until significant intraarterial levels are reached. If symptoms are present, they may include headache, dizziness, blurred vision, shortness of breath (especially with exertion), chest pain, rapid pulse, palpitations, malaise and fatigue, nocturia, or pedal edema. Signs of hypertensive disease vary and depend not only on the level of blood pressure but also include funduscopic changes with arteriolar narrowing, atrioventricular nicking, hemorrhages, exudates or papilledema, central nervous system changes and neurologic abnormalities, cardiac changes with gallop rhythm, cardiomegaly, tachycardia, ectopic ventricular beats, left ventricular hypertrophy or signs of congestive heart failure, pulmonary edema, and signs of renal insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hypertensive emergencies and urgencies: pathophysiology and clinical aspects. 394 53

In this discussion of infection control in patients with acquired immune deficiency syndrome (AIDS), attention is directed to nursing. Due to the fact that the majority of individuals who suffer with AIDS will be homosexual, intravenous drug users, or both, it is essential that the nurse historian be aware of his/her own feelings about the lifestyles of these patients. History-taking should be done in a nonjudgmental manner. A major pitfall to be avoided when taking a history is making assumptions about an individual's sexual preferences or activities based on the response to a simple question about marital status. It is important to note whether or not the person has a monogamous relationship or leads a polyandrous lifestyle. Another area that should be tactfully but explicitly explored when interviewing an individual who is homosexual or bisexual is the number of different sexual partners that he/she has been involved with on a weekly or monthly basis. Whether the patient has a history of sexually transmitted diseases should be determined. The use of recreational drugs should be explored. When taking the history of a client who uses intravenous drugs, it is important for the nurse to record the agents and sites of injection as well as to note whether the individual uses his/her own equipment. When reviewing the major body systems and the presence or absence of related symptoms, the nurse should note whether the client has experienced skin rashes/lesions, swollen lymph nodes, fever, extreme fatigue, weight loss, shortness of breath, changes in bowel habits, cuts or bruises that do not heal, and headaches, dizziness, blurred vision, or stiff neck. The physical examination of the individual with AIDS and an opportunistic infection usually will reveal positive findings in the central nervous system, respiratory system, gastrointestinal system, and/or the integumentary system, as well as the lymphatic system. As the leading cause of morbidity in the compromised host is infection, infection prevention should be regarded as a pragmatic necessity. 2 major things that nurses can do in the acute care setting to control infection are to limit the frequency of invasive or traumatic procedures and to reduce the acquisition of new potential pathogens.
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PMID:Infection control in the patient with AIDS. 608 77

In 1983, 949 cases of acute non-fatal illness consisting of headache, dizziness, blurred vision, abdominal pain, myalgia, and fainting occurred in the West Bank. Physical examination and biochemical tests were otherwise normal. There was no common exposure to food, drink, or agricultural chemicals among those affected. No toxins were consistently present in patients' blood or urine. Hydrogen sulphide gas was detected in low concentrations (40 parts per billion) at the site of the first outbreak. No other environmental toxins were found. The illness was thus of psychological origin and possibly triggered by the smell of hydrogen sulphide.
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PMID:The Arjenyattah epidemic. Home interview data and toxicological aspects. 614 May 60

A 78-year-old hypertensive woman suddenly developed blurred vision, followed shortly by dizziness, difficulty walking with a tendency to veer to the left, and vertical diplopia. Examination 3 weeks later revealed a unique neuro-ophthalmologic motility pattern, which may be described as periodic alternating skew deviation. This previously unreported motility disturbance was associated with downbeat nystagmus in our patient, and a focal lesion at the level of the interstitial nucleus of Cajal was demonstrated on computed tomography. The spectrum of physiologically related motility patterns--including periodic alternating nystagmus, cyclic oculomotor paralysis, see-saw nystagmus, periodic alternating gaze deviation, "ping-pong" gaze, and intermittent aperiodic alternating skew deviation--has been considered and is helpful in topical neuro-ophthalmologic diagnosis.
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PMID:Periodic alternating skew deviation. 621 44

The antiarrhythmic efficacy and safety of oral flecainide acetate and quinidine sulfate were compared in a double-blind, 16-center parallel trial involving 280 patients with chronic premature ventricular complexes (PVCs). Eighty-five percent of the flecainide patients had at least 80% suppression of PVCs, vs 57% of the quinidine patients (p less than 0.0001). Sixty-eight percent of the flecainide patients met the above criterion and also had complete suppression of couplets and beats of ventricular tachycardia, vs 33% of the quinidine patients (p less than 0.0001). PR and QRS intervals were prolonged by flecainide without clinical consequence, but they were not substantially affected by quinidine (p less than 0.0001). Quinidine prolonged JT (QT minus QRS) intervals significantly more than flecainide (p less than 0.05). Nineteen of 141 flecainide patients and 21 of 139 quinidine patients discontinued therapy because of side effects (p greater than 0.50). Flecainide side effects included dizziness, blurred vision, headache and nausea. Quinidine side effects included diarrhea, nausea, headache and dizziness. Flecainide was more effective than quinidine in suppressing chronic ventricular arrhythmias (especially complex forms), and thus is an important new antiarrhythmic agent.
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PMID:Flecainide versus quinidine for treatment of chronic ventricular arrhythmias. A multicenter clinical trial. 633 10

Twenty cancer patients who received chemotherapy were entered into a double-blind crossover design antiemetic study comparing 1 mg levonantradol, an investigational synthetic cannabinoid, to 10 mg prochlorperazine. Sixteen patients completed the crossover. For each antiemetic course, four doses of each study medication were given intramuscularly 2 hours before chemotherapy and then 2, 6, and 10 hours after chemotherapy administration. There were no statistical differences in patients' responses to levonantradol and prochlorperazine. The frequency of side effects was greater with levonantradol than with prochlorperazine. The most common side effect of levonantradol were somnolence, dry mouth, dizziness, tachycardia, postural hypotension, and blurred vision, while those for prochlorperazine were somnolence, dry mouth, and tachycardia.
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PMID:Double-blind multiple-dose crossover study of the antiemetic effect of intramuscular levonantradol compared to prochlorperazine. 637 43


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