Asunto(s)
Fibras de la Dieta/efectos adversos , Fentanilo/uso terapéutico , Galactanos/efectos adversos , Mananos/efectos adversos , Fosforilcolina , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Enfermedad Crónica , Modas Dietéticas , Combinación de Medicamentos/uso terapéutico , Estenosis Esofágica/inducido químicamente , Alcoholes Grasos/uso terapéutico , Fentanilo/administración & dosificación , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Dolor/tratamiento farmacológico , Gomas de Plantas , Polietilenglicoles/uso terapéutico , Surfactantes Pulmonares/uso terapéutico , Estados Unidos , United States Food and Drug AdministrationRESUMEN
Antacids show gastroprotective action against various irritants in experimental animals and enhance the healing of chronic gastroduodenal ulcers in humans but the mechanisms of these effects are unknown. The present study was designed to determine whether prostaglandin (PG) and epidermal growth factor (EGF), which also have protective and antiulcer properties, contribute to the action of antacids on rat's stomach. It was found that Maalox 70 and its active component, Al(OH)3, enhance significantly the healing of chronic gastric and duodenal ulcers observed during 7 and 14 days after their induction. Pretreatment with indomethacin caused a significant prolongation of ulcer healing, and this was accompanied by a significant reduction in PG and EGF formation, suggesting that both factors may be involved in ulcer healing. Maalox and Al(OH)3 failed to prevent the suppression of PG by indomethacin but were equally effective in ulcer healing in rats without and with indomethacin administration, suggesting that endogenous PG may not play any important role in the healing process by these drugs. Removal of salivary glands, the major source of EGF, also prolonged ulcer healing but, again, Maalox was as effective in ulcer healing as in rats with intact salivary glands. Our findings that Maalox at pH above 3.0 binds significant amounts of EGF, enhances the binding of EGF to the ulcer area, and stimulates mucosal growth, suggest that EGF may be involved in ulcer healing; however, because antacids are also effective after sialoadenectomy, EGF does not seem to be the major factor in ulcer healing by these drugs.
Asunto(s)
Hidróxido de Aluminio/uso terapéutico , Antiácidos/uso terapéutico , Factor de Crecimiento Epidérmico/fisiología , Hidróxido de Magnesio/uso terapéutico , Magnesio/uso terapéutico , Úlcera Péptica/tratamiento farmacológico , Prostaglandinas/fisiología , Animales , Combinación de Medicamentos/uso terapéutico , Concentración de Iones de Hidrógeno , Indometacina/farmacología , Ratas , Factores de Tiempo , Cicatrización de Heridas/fisiologíaRESUMEN
The aim of this study was to determine whether Fluor Protector, a fluoride varnish, applied to molars before orthodontic banding could prevent white spot formation. In the in vitro study 93 human premolars were used, divided in five different groups, representing different clinical situations. Each tooth was sliced in half, one as a control and the other as a test specimen. All tooth halves were stored in a demineralizing solution, in an attempt to induce white spot formation. In the in vivo study 104 molars (52 controls and 52 tests) of 28 orthodontic patients were involved. The 'split-mouth technique' was used. After evaluation of the results of both studies, it is evident that Fluor Protector is very effective in the prevention of white spot formation under molar bands.
Asunto(s)
Caries Dental/prevención & control , Fluoruros Tópicos/uso terapéutico , Diente Molar , Aparatos Ortodóncicos , Poliuretanos/uso terapéutico , Silanos/uso terapéutico , Silicio/uso terapéutico , Cementos Dentales , Materiales Dentales/uso terapéutico , Combinación de Medicamentos/uso terapéutico , Humanos , Técnicas In Vitro , Laca , Higiene Bucal , Distribución Aleatoria , Reproducibilidad de los Resultados , Resinas de Plantas , Propiedades de SuperficieRESUMEN
The hydrochlorothiazide component of Maxzide (Lederle Laboratories, Pearl River, NY) has been shown to be more bioavailable than the hydrochlorothiazide component of Dyazide (Smith, Kline and French Laboratories, Philadelphia, PA). The authors compared the antihypertensive effectiveness of a half-tablet of Maxzide (25 mg of hydrochlorothiazide and 37.5 mg of triamterene) to one capsule of Dyazide (25 mg of hydrochlorothiazide and 50 mg of triamterene) to determine if the difference in bioavailability would be reflected in differences in blood pressure control and metabolic changes. Thirty patients were studied in a randomized open-label crossover design study. There was a significant reduction in systolic blood pressure for both treatments although there was no difference in blood pressures at any time during the study between the two agents. There were no statistically significant differences between Maxzide and Dyazide in terms of metabolic changes for potassium, magnesium, glucose, cholesterol, triglycerides, uric acid, or calcium. Although the hydrochlorothiazide component of Maxzide is more bioavailable than that of Dyazide this did not translate into enhanced hypotensive efficacy.
Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hidroclorotiazida/uso terapéutico , Hipertensión/tratamiento farmacológico , Triantereno/uso terapéutico , Adulto , Anciano , Antihipertensivos/administración & dosificación , Antihipertensivos/farmacocinética , Disponibilidad Biológica , Combinación de Medicamentos/administración & dosificación , Combinación de Medicamentos/farmacocinética , Combinación de Medicamentos/uso terapéutico , Femenino , Humanos , Hidroclorotiazida/administración & dosificación , Hidroclorotiazida/farmacocinética , Hipertensión/sangre , Masculino , Persona de Mediana Edad , Distribución Aleatoria , Triantereno/administración & dosificación , Triantereno/farmacocinéticaRESUMEN
Parkinson's disease continues to be a tragic debilitator of close to half a million Americans. As more is learned about the disease, pharmacological treatment improves. Just recently, deprenyl became a part of our therapeutic armamentarium, and it appears that Sinemet CR will soon be following. It is hoped that these drugs will improve the quality and quantity of life for patients with PD until the disease can be cured.
Asunto(s)
Antiparkinsonianos/uso terapéutico , Carbidopa/uso terapéutico , Levodopa/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Fenetilaminas/uso terapéutico , Selegilina/uso terapéutico , Anciano , Carbidopa/administración & dosificación , Carbidopa/efectos adversos , Combinación de Medicamentos/administración & dosificación , Combinación de Medicamentos/efectos adversos , Combinación de Medicamentos/uso terapéutico , Femenino , Humanos , Levodopa/administración & dosificación , Levodopa/efectos adversos , Levodopa/farmacología , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/psicología , Calidad de Vida , Selegilina/administración & dosificación , Selegilina/efectos adversosAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Catalasa/uso terapéutico , Colina O-Acetiltransferasa/uso terapéutico , Fibromialgia/tratamiento farmacológico , Lipasa/uso terapéutico , Lipooxigenasa/uso terapéutico , Nucleotidiltransferasas/uso terapéutico , Sulfato Adenililtransferasa/uso terapéutico , Sulfurtransferasas/uso terapéutico , Combinación de Medicamentos/uso terapéutico , HumanosAsunto(s)
Alprostadil/análogos & derivados , Antiulcerosos/uso terapéutico , Úlcera Péptica Hemorrágica/prevención & control , Úlcera Gástrica/complicaciones , Estrés Fisiológico/complicaciones , Alprostadil/uso terapéutico , Hidróxido de Aluminio/uso terapéutico , Antiácidos/uso terapéutico , Combinación de Medicamentos/uso terapéutico , Humanos , Unidades de Cuidados Intensivos , Hidróxido de Magnesio/uso terapéutico , Misoprostol , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
The quest for a brighter, more attractive smile has fueled rapid growth in the marketplace for tooth whiteners. With names like BriteSmile, Denta-Lite, Ultra Lite and Whiter Teeth, these products are grabbing the attention of looks-conscious consumers. More than a dozen whiteners have flooded the market recently, most of them available by dentist prescription, a few being sold directly to consumers over the counter. There's no doubt these products work as whiteners, at least on mild to moderate stains. The looming questions is this: are they safe? This article explores that safety question and seeks to provide practicing dentists with some perspective on the issue. We don't pretend to have the definitive answer. As always, it's up to you, doctor, to decide what's best for your patients. It's up to us to provide information that helps you make those crucial decisions. That's our goal.
Asunto(s)
Dentífricos/uso terapéutico , Blanqueamiento de Dientes/métodos , Decoloración de Dientes/terapia , Peróxido de Carbamida , Dentífricos/efectos adversos , Combinación de Medicamentos/efectos adversos , Combinación de Medicamentos/uso terapéutico , Humanos , Peróxidos/efectos adversos , Peróxidos/uso terapéutico , Seguridad , Urea/efectos adversos , Urea/análogos & derivados , Urea/uso terapéuticoRESUMEN
The treatment of dyspepsia in the emergency department often consists of antacid in combination with viscous lidocaine, even though the specific etiology of the pain is frequently unknown. The efficacy of lidocaine as a component of symptomatic therapy was evaluated in a randomized, patient-blinded protocol. Patients presenting to the ED with dyspeptic symptoms were randomized to receive 30 mL of antacid (Mylanta II), or 30 mL of antacid plus 15 mL of 2% viscous lidocaine (GI cocktail). Patients recorded their pain score on an 11-cm linear analog scale prior to and 30 minutes after treatment. Seventy-six patients were enrolled; three were excluded from analysis due to incomplete data. Thirty-four patients were randomized to receive antacid and 39 to receive GI cocktail. Patients rated their baseline pain at 6.4 +/- 2.8 cm in the antacid group and 6.7 +/- 2.7 cm in the cocktail group (P greater than .50). Improvement in pain score with treatment was 0.9 +/- 2.9 cm in the antacid group compared with 4.0 +/- 3.4 cm in the GI cocktail group (P less than .0001). Assessment of pain relief using a five-point rating scale also indicated greater relief with GI cocktail therapy compared with antacid alone (P = .004). No adverse effects were noted with either treatment. We conclude that a single dose of antacid and viscous lidocaine provides a significantly greater degree of immediate pain relief than antacid alone in patients with dyspepsia.
Asunto(s)
Hidróxido de Aluminio/administración & dosificación , Antiácidos/administración & dosificación , Dispepsia/tratamiento farmacológico , Servicio de Urgencia en Hospital , Lidocaína/administración & dosificación , Hidróxido de Magnesio/administración & dosificación , Magnesio/administración & dosificación , Siliconas/administración & dosificación , Simeticona/administración & dosificación , Enfermedad Aguda , Hidróxido de Aluminio/uso terapéutico , Antiácidos/uso terapéutico , Combinación de Medicamentos/administración & dosificación , Combinación de Medicamentos/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Lidocaína/uso terapéutico , Hidróxido de Magnesio/uso terapéutico , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Simeticona/uso terapéuticoRESUMEN
One hundred febrile episodes in 89 neutropenic patients after cytotoxic chemotherapy were randomized to be treated with either ceftazidime or imipenem as initial monotherapy. The clinical characteristics of the two groups of patients were comparable. The response of the fever in patients who received imipenem was significantly better than that in those who received ceftazidime (77 versus 56%, respectively; P = 0.04), especially in those with microbiologically documented infection (81 versus 33%, respectively; P = 0.02). The in vitro susceptibilities and the clinical responses suggested that, with the possible exception of Pseudomonas spp., imipenem was more effective than ceftazidime in treating neutropenic infections caused by both gram-positive and -negative organisms. An additional 23 and 21% of the patients in the ceftazidime and imipenem groups, respectively, responded to the addition of cloxacillin and amikacin following failure of monotherapy. The majority of the treatment failures, relapses, and superinfections were related to resistant infective organisms such as methicillin-resistant Staphylococcus spp. and Pseudomonas spp. or disseminated fungal infections.
Asunto(s)
Agranulocitosis/complicaciones , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Ceftazidima/uso terapéutico , Cilastatina/uso terapéutico , Fiebre/complicaciones , Imipenem/uso terapéutico , Neutropenia/complicaciones , Adolescente , Adulto , Anciano , Antineoplásicos/efectos adversos , Bacterias/efectos de los fármacos , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/microbiología , Combinación Cilastatina e Imipenem , Combinación de Medicamentos/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Neutropenia/inducido químicamente , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como AsuntoAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Fibromialgia/tratamiento farmacológico , Lipasa/uso terapéutico , Lipooxigenasa/uso terapéutico , Catalasa/uso terapéutico , Colina O-Acetiltransferasa/uso terapéutico , Método Doble Ciego , Combinación de Medicamentos/uso terapéutico , Fibromialgia/diagnóstico , Humanos , Sulfato Adenililtransferasa/uso terapéutico , Sulfurtransferasas/uso terapéuticoAsunto(s)
Ventrículos Cerebrales/anatomía & histología , Medios de Contraste , Imagen por Resonancia Magnética , Meglumina/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Ácido Pentético/uso terapéutico , Sorbitol/análogos & derivados , Adulto , Combinación de Medicamentos/uso terapéutico , Femenino , Gadolinio/uso terapéutico , Gadolinio DTPA , HumanosRESUMEN
A new surgical technique for treating type A aortic dissections is described. It consists of the exclusive and extensive use of surgical glue without replacing a segment of the ascending aorta. Since 1984, 21 patients were operated on using this technique. No operative mortality occurred and one reoperation for redissection was required. The technique is simple and safe and yields excellent short-term and long-term results.
Asunto(s)
Aneurisma de la Aorta/cirugía , Disección Aórtica/cirugía , Formaldehído/uso terapéutico , Gelatina/uso terapéutico , Resorcinoles/uso terapéutico , Adhesivos Tisulares/uso terapéutico , Disección Aórtica/clasificación , Aorta/cirugía , Aneurisma de la Aorta/clasificación , Combinación de Medicamentos/administración & dosificación , Combinación de Medicamentos/uso terapéutico , Formaldehído/administración & dosificación , Gelatina/administración & dosificación , Humanos , Resorcinoles/administración & dosificación , Técnicas de Sutura , Adhesivos Tisulares/administración & dosificaciónRESUMEN
The treatment of cyclophosphamide-induced hemorrhagic cystitis has been difficult, with overall poor results using intensive and costly therapy. The authors evaluated the treatment of this problem in four patients with prostaglandin intravesical therapy. Each patient had failed to respond to conservative management. Carboprost tromethamine (Hemabate) was instilled into the bladder, with dwell times ranging from 45 to 60 minutes, three to four times a day for 4 to 5 days. Two of the patients required a second course with carboprost tromethamine at an increased concentration. A third patient's treatment was stopped after the first 5-day course because of intractable bladder spasms and persistent hematuria. In the three patients who completed the full course of therapy the hematuria resolved completely. The only side effect noted was bladder spasms, which were controlled in three of the four patients with oxybutynin chloride. This preliminary evaluation suggests that carboprost tromethamine may be a safe and effective bedside treatment of cyclophosphamide-induced hemorrhagic cystitis.
Asunto(s)
Carboprost/uso terapéutico , Ciclofosfamida/efectos adversos , Cistitis/prevención & control , Hematuria/prevención & control , Hemorragia/prevención & control , Prostaglandinas F Sintéticas/uso terapéutico , Trometamina/uso terapéutico , Adulto , Niño , Combinación de Medicamentos/uso terapéutico , Evaluación de Medicamentos , Femenino , Humanos , MasculinoAsunto(s)
Antimaláricos/uso terapéutico , Malaria/tratamiento farmacológico , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Sulfanilamidas/uso terapéutico , Animales , Combinación de Medicamentos/uso terapéutico , Resistencia a Medicamentos , Humanos , Lactante , Masculino , Plasmodium falciparumAsunto(s)
Antimaláricos/uso terapéutico , Malaria/tratamiento farmacológico , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Sulfanilamidas/uso terapéutico , Animales , Combinación de Medicamentos/uso terapéutico , Humanos , Kenia , Plasmodium falciparum/efectos de los fármacos , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
It is frequently assumed that, in general, combinations of antibiotics and similar chemotherapeutic agents are more efficient than the single chemotherapeutic, and that they can be combined without disadvantages for the activity of the single component. However, the specific properties of the combined substances, such as their antimicrobial spectrum and resistance, their pharmacokinetics and side effects, as well as their physical properties and formulation, have an enormous impact on the activity of combined chemotherapeutics. They may lead to an advantageous, but also to an indifferent or diminished activity of the combination in patients. Some of the important requirements for an advantageous combination of antibiotics and similarly functioning compounds will be reviewed and ways of avoiding mistakes are described.
Asunto(s)
Antibacterianos , Combinación de Medicamentos/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Animales , Combinación de Medicamentos/farmacología , Quimioterapia Combinada/farmacologíaRESUMEN
The effect of perfluorochemicals in combination with carbogen breathing on the response of SCK tumors of mice to fractionated irradiation was investigated. The SCK tumors of A/J mice were irradiated twice a day at 3 Gy per fraction (6 Gy per day), with a total dose of 18 Gy over 3 days. When the host animals were treated with an intravenous (iv) injection of 12 ml/kg of Fluosol-DA 20% before the first daily tumor irradiation and carbogen breathing during every X irradiation with Fluosol-DA 20% injection without carbogen breathing. The hypoxic cell fraction, as determined by an in vivo-in vitro cloning assay, decreased significantly, and the intratumor pO2, as determined with microelectrodes, was markedly increased by Fluosol-DA 20% injection and carbogen breathing. It was concluded that oxygenation of hypoxic cells in SCK tumors during the course of fractionated irradiation was improved by the iv injection of Fluosol-DA 20% and carbogen breathing.