PubMed Health⌕ Search

Biomedical subjects

A Amdisen

Publications and source records attributed to A Amdisen.

At least 19 recordsLinked to original sources
PubMed1991

No influence from topical application of EMLA cream before blood sampling on routine clinical chemistry and haematology measurements.

Blood samples were taken from both antecubital veins in ten healthy volunteers. One side was anaesthetized beforehand with EMLA cream covered with an occlusive dressing for 1 h and the other side served as a control. 19 routine clinical chemistry and haematology measurements were made. There were no clinically relevant alterations in any of the measurements. It is concluded that EMLA cream can be used to anaesthetize normal skin before blood sampling without any risk of distorting the results of the analyses of the blood.

Administration, Topical↗
PubMed1990

Change in renal tubular sodium and water handling during progression of polycystic kidney disease: relationship to atrial natriuretic peptide.

Renal tubular sodium and water handling determined by the lithium clearance technique, plasma concentrations of atrial natriuretic peptide (ANP), angiotensin II, aldosterone, arginine vasopressin (AVP), and urinary excretion of prostaglandin E2 (PGE2) were determined both during basal conditions and before and after intravenous sodium loading with a 2.5% sodium chloride solution in patients with polycystic kidney disease (PKD), ten with normal or slightly reduced kidney function (PKDN) and seven with moderately reduced kidney function (PKDR), and in 15 healthy controls. In PKDN tubular function was normal, whereas in PKDR both proximal and distal reabsorption of sodium and water were reduced. Angiotensin II and aldosterone were normal in both groups of patients. During basal conditions ANP was higher in PKDR than in PKDN. PGE2 was significantly higher in PKDR than in PKDN. For all patients significant correlations were found between GFR and both ANP (rho = -0.51, n = 17, P less than 0.05) and PGE2 (rho = -0.53, n = 17, P less than 0.05). It is concluded that renal sodium handling is normal in the early stages of PKD. With deterioration of kidney function both proximal and distal tubular reabsorption of sodium is reduced and the accompanying changes in ANP and PGE2 may be compensatory phenomena counteracting declining glomerular filtration rate.

Adult↗
PubMed1989

Atrial natriuretic peptide and exaggerated natriuresis during acute hypertonic volume expansion in essential hypertension.

In patients with essential hypertension and healthy controls, plasma levels of atrial natriuretic peptide (ANP), angiotensin II (Ang II), aldosterone (Aldo), arginine vasopressin (AVP) and urinary excretion of prostaglandin E2 (PGE2) were measured under basal conditions, and before and after acute volume expansion with a 2.5% hypertonic sodium chloride solution. Tubular sodium handling was assessed by the lithium clearance technique. Under basal conditions ANP was increased in patients compared with controls (9.0 pmol/l versus 7.5 pmol/l, P less than 0.01). In response to acute volume expansion patients exhibited exaggerated increases in ANP (5.3 pmol/l versus 3.0 pmol/l, P less than 0.05), exaggerated natriuresis, and an abnormal decrease in fractional proximal and distal tubular sodium reabsorption (PFRNa and DFRNa, respectively). Furthermore, during comparable urinary flow rates, urinary PGE2 excretion was decreased in patients compared with controls (266 pg/min versus 705 pg/min, P less than 0.05). No differences were found between patients and controls in Ang II, Aldo or AVP under basal conditions. Both groups responded to hypertonic acute volume expansion with comparable decreases in Ang II and Aldo, and an increase in AVP. It is concluded that in essential hypertension ANP is increased under basal conditions and the increase in natriuresis and ANP is exaggerated during acute volume expansion. The exaggerated natriuretic response to acute volume expansion resulted from an altered handling of sodium in both proximal and distal tubules.

Adult↗
PubMed1989

Abnormal glomerular and tubular function during angiotensin converting enzyme inhibition in renovascular hypertension evaluated by the lithium clearance method.

Glomerular filtration rate (GFR) and tubular function were measured by means of the lithium clearance technique in 14 patients with renovascular hypertension (RVH) and eight patients with essential hypertension (EH) before and after oral administration of captopril 25 mg. In RVH captopril reduced 51-Cr-EDTA clearance (67.3 (median) to 47.5 ml min-1, P less than 0.01), proximal absolute reabsorption of fluid (53.9 to 41.5 ml min-1, P less than 0.01) and distal absolute reabsorption of sodium (2195 to 1402 mumol min-1, P less than 0.01), whereas proximal fractional reabsorption increased slightly (77.5 to 80.2%, P less than 0.02). In EH, however, these parameters were practically unaffected by captopril. In both RVH and EH plasma concentrations of angiotensin II and aldosterone were reduced after captopril, but atrial natriuretic peptide in plasma and urinary excretion rate of prostaglandin E2 were unchanged. Blood pressure decreased after captopril in both groups, but the maximum fall in systolic BP was more pronounced in RVH (22%) than EH (13%). It is concluded that angiotensin converting enzyme inhibition markedly reduced absolute reabsorption in both the proximal and distal tubules in RVH, in contrast to EH, predominantly due to fall in the GFR, and that the slight increase in proximal fractional reabsorption may be attributed to a reduction in the hydrostatic pressure in the peritubular vessels.

Adult↗
PubMed1988

Use of lithium in the medically ill.

For more than one hundred years (about 1845-1950), lithium salts were used to treat disorders belonging to 'the uric acid diathesis' ('gouty diseases'). It was introduced into modern psychiatry as an antimanic agent, but its current use is mostly as a prophylactic in bipolar and unipolar manic-depressive illness. In the present context, however, this psychiatric use may, in some instances, create special nonpsychiatric problems such as lithium poisoning, renal diabetes insipidus, and weight gain. Moreover, most lithium patients are outpatients, so that medical complaints caused by the treatment are in most cases presented to the general practitioner, the neurologist, the nephrologist, the cardiologist, etc. rather than to the psychiatrist. Lithium treatment is frequently accompanied by both short-term and long-term side effects and some of these, e.g. the thyroid-depressing effect and leukocytosis, may be medically exploited. Like manic-depressive illness, some medical disorders such as certain types of headache have a periodic course and appear to respond favorably to long-term lithium treatment. Cooperation between researchers in biological psychiatry and nephrologists has resulted in the suggestion that lithium may be used as an indicator of proximal sodium and water reabsorption, which has later led to the suggestion that the renal lithium clearance is an indicator of proximal renal tubular function.

Bipolar Disorder↗
PubMed1987

History of lithium.

Explore the source record for details and available documents.

History, 19th Century↗
PubMed1987

Zuclopenthixol acetate in Viscoleo--a new drug formulation. An open Nordic multicentre study of zuclopenthixol acetate in Viscoleo in patients with acute psychoses including mania and exacerbation of chronic psychoses.

Eighty-three acutely disturbed, psychotic patients were included in an open multicentre study. The aim of the study was to evaluate the clinical effect of zuclopenthixol acetate in Viscoleo (CPT-A). Each patient received from one to four intramuscular injections of CPT-A during the 6-day study period. The duration of action after one injection was between 2 and 3 days and doses from 50 mg to 150 mg were sufficient for most patients. Treatment with CPT-A caused a pronounced and rapid reduction of the psychotic symptoms. At the end of the 6-day test period the mean total score on BPRS in acute non-manic and exacerbated chronic patients was reduced by more than 50 per cent. In acute manic patients the mean total score on BRMS was reduced by 57 per cent already 1 day after injection. Rapidly after the injection of CPT-A a useful short-acting sedation can be expected, but the risk for oversedation even after a second injection is low. The frequency of unwanted effects, including extrapyramidal reactions, was low and the severity of symptoms was most often mild. With a rapid onset of action, a duration of effect of 2 to 3 days, and few and mild side effects, CPT-A offers advantages over the neuroleptic preparations conventionally used in the initial treatment of acutely disturbed, psychotic patients.

Acute Disease↗
PubMed1987

Effect of intravenous sodium loading on renal tubular handling of sodium and water in unilaterally nephrectomized humans.

Glomerular filtration rate (GFR), proximal absolute and fractional reabsorption of isotonic fluid (PAR and PFR) and distal absolute and fractional reabsorption of sodium (DARNa and DFRNa) were measured using the lithium clearance technique in nine unilaterally nephrectomized people (UNP) 1-11 years postnephrectomy and in 14 controls before, during and after an intravenous sodium load. Glomerular filtration rate per kidney was 53% higher in UNP and decreased slightly but significantly (p less than 0.01) in both groups during sodium loading. The PAR per kidney was significantly higher in UNP (p less than 0.01) but PFR was the same as in controls. Both groups responded to sodium loading with a significant decrease in both PAR and PFR. In UNP, DARNa per kidney was significantly higher than in controls (p less than 0.01) but DFRNa was the same in the two groups. Sodium loading resulted in a further increase in DARNa and a decrease in DFRNa in both groups. Both groups responded to sodium loading with a similar increase in fractional sodium excretion. It is concluded that unilateral nephrectomy is followed by an increase in GFR, PAR and DARNa but with maintenance of fractional reabsorption in both proximal and distal tubuli. In response to an intravenous sodium load, the remnant kidney is able to respond in a normal way with a further increase in DARNa. The adjustments necessary to maintain sodium balance after unilateral nephrectomy take place in both proximal and distal tubuli.

Adult↗
PubMed1987

Abnormal proximal tubular sodium handling in normotensive patients with chronic glomerulonephritis and normal glomerular filtration rate.

In 11 normotensive patients with biopsy verified chronic glomerulonephritis and 14 controls, glomerular filtration rate (GFR), proximal and distal tubular handling of sodium determined by the lithium clearance technique, and overall tubular sodium handling determined by absolute and fractional sodium excretion were measured before, during and after intravenous infusion of a 2.5% sodium chloride solution. Patients and controls were comparable by means of GFR in that no significant differences were found between the two groups either before, during or after sodium chloride infusion. During infusion both groups responded by a decrease in GFR (p less than 0.01 in both groups). Patients exhibited an increased natriuretic response during infusion both when measured as absolute and fractional sodium excretion (p less than 0.05 both). During the infusion the increase in absolute proximal output and decrease in fractional proximal and distal tubular sodium reabsorption were more pronounced in patients than in controls (p less than 0.05). It is concluded that patients with chronic glomerulonephritis at a very early stage of the disease where blood pressure and GFR are still normal respond with exaggerated natriuresis to hypertonic sodium chloride infusion. The exaggerated natriuresis is due to a decreased fractional proximal tubular sodium reabsorption in response to sodium loading.

Adolescent↗
PubMed1986

Serum concentrations and clinical effect of zuclopenthixol in acutely disturbed, psychotic patients treated with zuclopenthixol acetate in Viscoleo.

Zuclopenthixol acetate, 5%, in Viscoleo was administered IM to 19 acutely disturbed, psychotic patients in doses of 50-150 mg. Fifteen patients received one injection, whereas four of the patients had two or three injections, usually with intervals of 3 days. The zuclopenthixol concentrations in serum were measured in series of samples taken from each patient during a 3-day period following the injection. In patients given identical doses serum concentrations of about the same order were obtained. Significant and good correlations were found between dose and maximal serum concentration and between dose and area under the serum concentration curve. The average serum concentration curve obtained when adjusting the data to a 100 mg dose has a maximum of 41 ng/ml after about 36 h, decreasing to 15 ng/ml after 72 h. A dose of 50-150 mg zuclopenthixol acetate in Viscoleo appeared to be sufficient for controlling the symptoms for most acutely disturbed, psychotic patients. The frequency of side effects, including extrapyramidal reactions, was low and the adverse reactions mostly mild, indicating that the risks for severe complications generally might be minimal. With a rapid onset of action, few and mild side effects, good tolerability at the injection site, and a duration of effect of 2-3 days, zuclopenthixol acetate in Viscoleo appears to offer advantages compared to conventional neuroleptic treatment in patients in whom an acute, calming effect is desired.

Adult↗
PubMed1986

Relationship between standardized twelve-hour serum lithium, mean serum lithium of the 24-hour day, dose regimen, and therapeutic interval. An evaluation based on pharmacokinetic simulations.

In conclusion, it may be stated that the twelve-hour serum lithium value is essentially arbitrary and can only be used as an unambiguous guide in an intraindividual context. A single SLi value which correlates strongly enough with any of the known clinical responses to lithium to be of clinical importance is as yet unknown, with the one exception that impending lithium intoxication must be regarded as so serious a condition that the interindividually ambiguous 12h-stSLi should generally be regarded as a bad omen when it reaches levels above 1.40 mmol/l. Given that the working hypothesis (that the 24-hour mean of SLi is of crucial importance for many of the clinical effects of long-term lithium treatment) is correct, and in view of interindividual variations in human lithium pharmacokinetics, it cannot be generally acceptable to lower and narrow the "therapeutic range" to, for example, 0.50-0.80 mmol/l. Correspondingly, the suggestion that the daily dose should be kept below arbitrarily chosen low lithium dosages is irrelevant; it is clear that 12h-stSLi and the daily dose should be individualized within wider parameters, with due consideration of the biological half-life of lithium in the particular patient, the desired MSLi, and the absorption rate of lithium, which mainly depends on the dissolution properties of the drug preparation. In general, no strong correlation between the 12h-stSLi and the mean SLi over the 24-hour day can be expected as far as representative groups of lithium patients are concerned.

Circadian Rhythm↗
PubMed1985

Lithium.

Explore the source record for details and available documents.

Humans↗
PubMed1979

Renal function and plasma aldosterone during acute lithium intoxication.

Studies on plasma aldosterone, total serum protein, electrolytes, osmolal concentrations in serum and urine, creatinine, lithium and osmolal clearances were carried out on 14 patients suffering from lithium intoxication. The determinations were done on samples obtained on admission and during the following twelve days of treatment with hemodialysis, sodium chloride loading, or forced diuresis. Plasma aldosterone and total serum protein were increased; serum sodium concentrations and creatinine clearances were decreased on admission. Serum osmolality was normal; urine osmolal concentration was just above that in plasma. The results showed that the lithium intoxicated patients were moderately depleted of sodium and water on admission. Plasma aldosterone, total serum protein and serum sodium were normalized during treatment. Creatinine clearance increased but did not normalize in all patients. Renal concentrating tests were performed in five patients three to four weeks after lithium intoxication. The renal concentrating ability was reduced in all. The elevated plasma aldosterone seen in lithium intoxication might have been a result of sodium and water depletion. It is suggested that impaired renal concentrating ability induced by lithium may make some patients more susceptible to conditions which can lead to sodium and water loss, and thereby to lithium intoxication.

Acute Disease↗
PubMed1979

Lithium treatment and kidney function. A survey of 237 patients in long-term treatment.

Kidney function has been examined in 237 patients who in the autumn of 1977 were in lithium treatment at the Psychiatric Hospital in Risskov, most of them as outpatients. The average age was 42 years. The patients had been given lithium treatment for 0.5-17 years, mean duration 5 years. The mean lithium dosage was 33 mmol/day and the mean 12-hour serum lithium concentration 0.85 mmol/l. Glomerular filtration rate was assessed through determination of 24-hour creatinine clearance and serum creatinine, in some cases iothalamate clearance. Water excretion was assessed through determination of 24-hour urine volume and in some cases urine osmolality after 26 hours of fluid deprivation. Creatinine clearances, serum creatinine concentrations, and urine volumes were subjected to multiple regression analysis with various clinically relevant predictor variables. Affection of glomerular filtration rate was only moderate and progressed slowly. The data indicate that the risk of renal insufficiency and terminal azotemia is remote even when lithium is given for many years. A large number of the patients had altered water excretion with polyuria or lowered urine concentrating ability or both. Due to the extra fluid loss these patients are apt to develop dehydration, and they may then be in danger of lithium poisoning. We hypothesize that lithium-induced changes of kidney function may become less frequent and less pronounced if patients are maintained at serum lithium levels somewhat lower than those employed in the group studied here. We recommend careful monitoring of serum lithium levels, regular control of kidney function, and extra caution when physical illness or additional drug treatment may lead to disturbance of fluid and electrolyte balance.

Adult↗
PubMed1979

Plasma neutral amino acids in mania and depression: variation during acute and prolonged treatment with L-tryptophan.

The free tryptophan and plasma neutral amino acids including kynurenine have been determined before treatment, after a single load, and during prolonged treatment with L-tryptophan on a bipolar manic-depressive patient who has shown resistance to current treatments. The data of the patient were compared with the data of healthy control subjects in order to evaluate the availability of tryptophan to the brain. A relative deficiency of tryptophan in the plasma, as measured by the ratio of tryptophan to those amino acids which compete with tryptophan during transport processes, was found in the patient. Further, the patient showed an increased area under curve of plasma tryptophan after a load, and an increase in the competing amino acids during the load compared to a decrease in the control subjects. During the treatment with L-tryptophan the competing amino acids increased in the plasma. The results suggest that the patient suffered from a dysfunction of the processes which mediate active transport of tryptophan and other large neutral amino acids into tissues including the brain.

Amino Acids↗
PubMed1979

Chronic interstitial nephropathy in patients on long-term lithium treatment.

One-hundred and ten patients treated with lithium for more than six months were studied in order to determine the prevalence of lithium induced nephropathy. Eighteen of 69 patients (26 per cent) who had been treated for more than two years presented a chronic interstitial nephropathy characterized by a marked decrease in renal concentrating ability with a disproportionate preservation of glomerular filtration rate. Histologically, increased amounts of fibrotic tissue in the medulla and the cortex were found together with tubular atrophy. In 40 per cent of the patients who underwent renal biopsy, cystic formations in the cortex were found. The impairment of renal concentrating ability could be related to the duration of lithium treatment and the degree of tubular damage correlated with the degree of impairment of renal concentrating ability. Lithium induced, chronic nephropathy is a rather common complication of long-term lithium treatment and reduces the patients capacity to regulate water and electrolyte metabolism. As water and electrolyte loss appears to precede the slowly progressing lithium intoxication, the main hazard of lithium induced nephropathy is lithium intoxication.

Adult↗