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Biomedical subjects

A K Wittkowsky

Publications and source records attributed to A K Wittkowsky.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Neuroleptic-induced catatonia after abrupt withdrawal of amantadine during neuroleptic therapy.

Catatonic reactions to high-potency neuroleptic drugs have been described in the literature. Our patient developed neuroleptic-induced catatonia (NIC) after abrupt withdrawal of amantadine, a dopaminergic agent that has been implicated in neuroleptic malignant syndrome (NMS) on its discontinuation. This case report adds support to the hypothesis that NIC and NMS are 2 syndromes on a continuum of dopamine blockade, each of which may be treated with or uncovered by amantadine therapy.

Adolescent↗
PubMedDate not supplied

Heparin monitoring in acute thrombosis associated with antiphospholipid antibody syndrome.

Antiphospholipid antibody syndrome is associated with recurrent thromboembolism and the presence of antibodies directed against negatively charged phospholipids. Despite significant hypercoagulability, patients with the disorder often have elevated baseline activated partial thromboplastin times. Although heparin is indicated for the treatment of acute thrombosis, heparin monitoring is complicated by laboratory test interference. A practical treatment approach involves patient-specific screening for a reagent insensitive to the presence of the inhibitor, and determination of a reagent-specific therapeutic range in seconds that corresponds to heparin serum concentrations of 0.2-0.4 U/ml. Other monitoring methods, including using the patient's baseline activated partial thromboplastin time or using an antifactor Xa activity assay, have not been reported or studied but may offer alternatives for heparin monitoring in patients with coagulation laboratory test interference associated with antiphospholipid antibody syndrome.

Acute Disease↗
PubMedDate not supplied

Influence of bile acid replacement on cyclosporine absorption in a patient with jejunoileal bypass.

Jejunoileal bypass reportedly inhibits the absorption of cyclosporine. In patients with malabsorption syndromes, bile acid replacement has been given to enhance the absorption of cyclosporine. A candidate for heart transplantation with New York Heart Association class IV heart failure and a jejunoileal bypass received cyclosporine alone and with concomitant ursodiol administration to determine whether therapeutic cyclosporine plasma concentrations would be attainable after heart transplantation. There were no differences in peak concentration, time to peak, area under the serum concentration versus time curve, or bioavailability of oral cyclosporine when administered alone or with ursodiol. Plasma cyclosporine concentrations were consistent with those in the general population.

Cyclosporine↗
PubMedDate not supplied

The stroke pharmacopeia: current medical therapies.

Drug therapies that inhibit or reverse thrombus formation are important components of the management of acute ischemic stroke. The role of antiplatelet and anticoagulant therapies in stroke prevention has been defined, but further research is needed to confirm the possible benefits of aspirin, heparin, and low-molecular-weight heparin products in acute ischemic stroke. Recently, double-blind, placebo-controlled studies have evaluated the role of the thrombolytic agents streptokinase and tissue plasminogen activator (t-PA) in patients with acute ischemic stroke. Intravenous t-PA, administered within 3 hours of symptom onset at a dose of 0.9 mg/kg, is safe and effective in carefully selected patients.

Acute Disease↗