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Biomedical subjects

A K Done

Publications and source records attributed to A K Done.

At least 19 recordsLinked to original sources

Treatment of fever in 1982: a review.

While there is room for questioning the need, or even advisability, of routine antipyretic therapy, the available data do not yet constitute any sort of a contraindication. There are reasons for individualizing the decision. However, having once decided, there is no compelling reason for selecting one antipyretic over any other, and aspirin remains the most satisfactory in light of the available evidence. Some serious theoretic questions persist about the safety of acetaminophen use in sick persons, and clearly there are some precautions that should be taken with regard to the doses of flavored preparations of this and any future products whose attractiveness to children is thus enhanced.

Acetaminophen↗

Pharmacokinetics of chloramphenicol and chloramphenicol succinate in infants and children.

The metabolism and elimination of chloramphenicol-3-monosuccinate was studied in 45 infants and children, ages 3 days to 16 years, during intravenous administration. The apparent half-life of chloramphenicol was extremely variable, ranging from 1.7 to 12.0 hours with a mean of 5.1 hours. Apparent half-lives were inversely correlated with age. Chloramphenicol-S serum concentration declined biexponentially in most patients, with an estimated mean initial half-life of 0.7 hours and a subsequent longer mean half-life of 2.2 hours. Chloramphenicol-S persisted in serum up to six hours after a dose, and comprised a significantly larger fraction of total chloramphenicol in the serum of infants under one month of age than in older infants and children. A widely variable fraction of the administered chloramphenicol-S dose, with a mean of 33%, was excreted in the urine unchanged and was, therefore, not bioavailable in active form. Mean renal clearance of chloramphenicol-S was 259.5 ml/minute/1.73 M2, four times the mean creatinine clearance, indicating active tubular secretion. Variable hydrolysis and renal elimination of nonhydrolyzed chloramphenicol-S reduces the bioavailability of the antibiotic and appears to contribute substantially to the wide variation in apparent half-life and poor correlation between dose and serum concentration of free chloramphenicol.

Adolescent↗

Pharmacokinetics of severe theophylline intoxication managed by peritoneal dialysis.

In a patient severely poisoned with theophylline, saturation kinetics were demonstrated at serum concentrations > 35 micrograms/ml with subsequent conversion to first order kinetics (t 1/2 = 5.4 h). Peritoneal dialysis was used to enhance the drug's removal. The mean theophylline clearance was greater for dialysate (5.11 ml/min) than for urine (1.98 ml/min) or gastric fluid (0.32 ml/min). Urinary elimination occurred as a constant first order process (t 1/2 = 4.3 h). Peritoneal dialysis is a valuable early adjunct in the management of severe theophylline intoxication.

Child, Preschool↗

Aspirin dosage for infants and children.

The labeled dosage schedule that has long been on pediatric aspirin preparations is at variance with the recommendation in authoritative medical references, studies demonstrating antipyretic effectiveness in children, and the prescribing habits of pediatricians as revealed by a poll conducted by the authors. Aspirin pharmacokinetics are influenced by a number of physiologic factors, as well as by dosage, and complicate the problem of assuring safe and effective pediatric use. Basic pharmacokinetic considerations indicate that the increase in size of individual doses needed to assure therapeutic salicyate blood levels, thereby removing the temptation of parents to administer the drug too often, is made permissible (i.e., safe while effective) by expanding the interdose interval to four hours instead of three. A revised pediatric aspirin disage schedule is presented that better meets the practices of the pediatric community and the needs of consumers.

Age Factors↗

Simultaneous measurements of acetaminophen and salicylate in plasma by liquid chromatography.

We describe a "highly-performance" liquid chromatographic method in which 8-chlorotheophylline is used as an internal standard to determine acetaminophen and salicylate simultaneously in plasma samples. Therapeutic as well as toxic concentrations can be determined on samples as small as 50 micro L, which makes the method particularly useful for determinations on samples from young children. The procedure requires a simple extraction of the drugs, and the chromatography is completed in 6 min.

Acetaminophen↗

Phencyclidine overdose: an emerging concept of management.

Emergency physicians should be prepared to treat overdosage from phencyclidine, a common street drug abused throughout North America. A dearth of laboratory resources to establish the diagnosis makes it essential that diagnoses include awareness of symptomatology. A specific therapeutic approach utilizing ion-trapping by continuous gastric suctioning and acidification of urine and/or blood can be used successfully to treat these patients.

Humans↗

Aspirin overdosage: incidence, diagnosis, and management.

The importance of aspirin as a cause of poisoning in children has declined dramatically with safety packaging and reductions in the dose of flavored children's aspirin per package. Although flavoring entices children to ingest more tablets, the increment is less than the dose differential between the children's and adults' preparations, and so the latter pose the greater hazard in the individual case. Chronic poisoning of children during therapy with aspirin is aggravated by the peculiar kinetics of the drug, but is preventable and constitutes no essential basis for the substitution of acetaminophen, which may not be devoid of risk factors in sick children. Salicylate levels are essential in the diagnosis and management of intoxication. In treatment, emphasis should be on trapping salicylate in the plasma and eventually the urine--through ionization to prevent its entry into the brain.

Aspirin↗