Growth and development until 18 months of children exposed to tocolytics indomethacin or nylidrin.

Indomethacin, a prostaglandin synthesis inhibitor, is a more efficient tocolytic than the beta-sympathomimetic nylidrin, but causes more frequent unwanted effects in the neonatal period. In order to elucidate the effects on neurodevelopment, infants randomly exposed in utero to either compound were followed up to 18 months. A total of 93 children (40 exposed to nylidrin and 53 exposed to indomethacin) were examined at the age of 12 months. A detailed neurological examination was carried out in 44 of these infants at the age of 18 months. At the age of 12 months the children in the indomethacin group showed poor outcome (death or severe BPD and/or CP and/or severe ROP) in 23% and the children in the nylidrin group in 5% (p = 0.039, Fisher Exact Test). Concerning the children born during tocolysis the corresponding figures were 73% and 13% respectively (p = 0.002, Fisher Exact Test). The growth of the children did not differ significantly between the two treatment groups. Neurological assessment at the age of 18 months revealed more subnormally scoring children in the indomethacin group, but the differences were not significant. It was concluded that the higher incidence of poor outcome and a lest favourable neurological development in the indomethacin group do not support indomethacin's position as the drug of choice for tocolysis.

The effects of indomethacin and a beta-sympathomimetic agent on the fetal ductus arteriosus during treatment of premature labor: a randomized double-blind study.

To study the effect of maternal indomethacin or nylidrine hydrochloride treatment on the fetus ductus arteriosus and the pulmonary artery, 27 women with threatened preterm labor between 24 and 34 weeks' gestation were studied by echocardiography. Fourteen women were treated with indomethacin and 13 with nylidrin. Both systolic and diastolic velocities in the ductus increased after administration of indomethacin indicating constriction in nine fetuses, and exceeded the corresponding velocities in the fetuses of the nylidrin group (p = 0.001). However, there were no changes in pulmonary artery flow velocities (p greater than 0.5). In the indomethacin group, there was a significant linear positive relationship between the gestational age and the change in ductal flow velocity. Three of the nine patients with ductal constriction also had tricuspid regurgitation. These findings indicate that indomethacin, not nylidrin, causes transient constriction of the ductus arteriosus and the constrictive response increases with the gestational age. We recommend echocardiographic surveillance of fetal hemodynamics when prostaglandin synthesis inhibitors are used in the treatment of spontaneous preterm labor.

Nylidrin HCL in the treatment of symptoms of the aged: a double-blind placebo controlled study.

This study was designed to assess the effectiveness and the safety of nylidrin HCL in the geriatric patient and mild to moderate symptoms of cognitive, emotional and physical impairment. Following a 3 week placebo washout, 60 patients received either nylidrin HCL or placebo for 12 weeks. Efficacy evaluations were made utilizing the Sandoz Clinical Assessment Geriatric (SCAG) Scale, a nurse's rating of ward behavior (SCASNO), the Hamilton Psychiatric Rating Scale for Depression, and 2 of the Katz Adjustment Scales. Significant improvement in symptom severity was demonstrated in the nylidrin group as compared to the placebo group. There were no abnormalities of clinical significance in the safety measurements and few side effects were reported.

[Effects of beta-sympathicomimetics on ionogram, transaminases, and ECG in pregnancy (author's transl)]. / Der Einfluss von beta-Sympathikomimetika auf Ionogramm, Transaminasen und EKG in der Schwangerschaft.

Beta-adrenergics have recently come in the focus of clinical, physiological, and pharmacological research. The side-effects of tocolytically active substances are under thorough study at present. The authors checked the laboratory values recorded from 45 patients in pregnancy. Electrocardiographic follow-up checks were also conducted, with the view to establishing the effects of Dilatol and Partusisten on both the electrolyte balance and myocardium.--The results are described and discussed, and conclusions are suggested.

[Prevention of premature birth with nylidrin and verapamil (author's transl)]. / Hemmung der drohenden Frühgeburt mit Nylidrin und Verapamil

108 cases of threatened premature birth were treated with i.v. drip-infusion, followed by oral treatment with Dilatol and Isoptin. This was successful in 81% of cases. A birth-weight of over 2500 g was considered a positive result. In 14% of cases there were side effects. The results are compared with earlier investigations.