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Biomedical subjects

A W Gotta

Publications and source records attributed to A W Gotta.

At least 19 recordsLinked to original sources
PubMed2001

Parecoxib. Pharmacia corp.

Pharmacia (formerly Monsanto) is developing parecoxib, an injectable COX-2 inhibitor, for the management of post-surgical acute pain [287279], [313957]. By January 1999, the compound was in phase III trials for this indication [312280]. In October 2000, Pharmacia submitted an NDA for parecoxib sodium for the management of acute pain to the FDA. The company anticipated a 12-month review of the NDA [387654] but received a 'not approvable' letter in July 2001, indicating there were deficiencies in the filing; at this time, Pharmacia anticipated refiling before the end of 2002 [415668]. Under a license agreement with Pharmacia Corp, parecoxib (designated YM-177) is being developed in Japan by Yamanouchi [392030]. Prior to the FDA ruling, in June 2000, the company anticipated that the compound would be launched by 2001 [370466]. In March 2000, Merrill Lynch predicted that parecoxib would be filed in the third quarter of 2000 [361969], [382577]. By May 2001, the analysts revised their predictions to launch in 2002 [411811].

Journal Article↗
PubMed1991

Peribulbar anesthesia. Effect of bicarbonate on mixtures of lidocaine, bupivacaine, and hyaluronidase with or without epinephrine.

The pH-adjustment of local anesthetic solutions with sodium bicarbonate may shorten onset time and improve spread of neural blockade. The authors undertook a prospective, double-masked, randomized study to see if a pH-adjusted mixture of lidocaine, bupivacaine, and hyaluronidase had faster and more complete onset of neural blockade, when used for peribulbar anesthesia. Eighty patients were randomly assigned to four groups and received a peribulbar block with one of four mixtures: group 1 (L) = 2% lidocaine, group 2 (LPH) = 2% lidocaine with 0.06 meq/ml sodium bicarbonate, group 3 (LE) = 2% lidocaine with 1:100,000 epinephrine (commercially prepared), or group 4 (LEPH) = 2% lidocaine with 1:100,000 epinephrine with 0.06 meq/ml sodium bicarbonate. To 5 ml of each of the preceding groups, 5 ml of 0.75% bupivacaine and 150 units of hyaluronidase was added. After each block, extraocular muscle movement was followed in each quadrant until akinesia developed. In the event of incomplete akinesia, blocks were supplemented at 20 minutes. The LPH group had the fastest onset to complete akinesia (7.0 +/- 2.0 minutes, mean +/- SEM) when compared with the onset time of all other groups (group 1 = 11.5 +/- 1.9 minutes, group 4 = 13.1 +/- 1.4 minutes, and group 3 = 16.0 +/- 1.8 minutes, significance greater than 95% by analysis of variance). Furthermore, when compared with group 3 by analysis of variance, group 4 had a faster onset time. The authors conclude that pH-adjustment of solutions with bicarbonate of either lidocaine/bupivacaine/hyaluronidase or commercially prepared lidocaine with epinephrine/bupivacaine/hyaluronidase decreases the onset time of peribulbar anesthesia.

Anesthesia, Local↗
PubMed1990

pH-adjusted bupivacaine and hyaluronidase for peribulbar block.

The onset of akinesia of the extraocular muscles was assessed after peribulbar block with a plain or pH-adjusted solution of 0.75% bupivacaine and hyaluronidase. Thirty-five patients were randomly assigned to receive either 0.75% bupivacaine with hyaluronidase 15 units/ml (pH 5.45 +/- 0.12) or the same pH-adjusted solution (0.15 mEq sodium bicarbonate per 30 ml of 0.75% bupivacaine to give a final pH of 6.82 +/- 0.09) in a double-blind, prospective manner. Onset of akinesia was determined to the nearest minute. Supplemental injections were given after 20 min in the event of incomplete akinesia. The group receiving pH-adjusted bupivacaine had a statistically faster onset time for complete akinesia than did the control group (5.3 +/- 1.2 min vs. 14.3 +/- 2.3 min, respectively; P less than 0.001). Five of 17 patients in the control group required a supplemental injection, whereas only one of 17 patients in the treatment group had a supplemental block at 20 min (P less than 0.05). Thus, pH adjustment of a solution of bupivacaine and hyaluronidase with sodium bicarbonate hastens the onset time and improves the initial success rate of peribulbar block.

Bupivacaine↗
PubMed1986

Platelet aggregation and the pharmacology of local anaesthetics.

Local anaesthetics significantly inhibit platelet aggregation and prolong the lag period of collagen-induced aggregation, but only at toxic concentrations. This appears to be due to stabilization of the platelet membrane. While the phenomenon is not clinically significant, the platelet may serve as a readily available, easily harvested, renewable human cellular model for studying the pharmacology of local anaesthetics.

Adenosine Diphosphate↗
PubMed1981

Anatomical dead space and airway resistance after glycopyrrolate or atropine premedication.

The effects of atropine and glycopyrrolate on anatomical dead space, one and three second forced expiratory volume, maximal expiratory flow rate, and total forced expiratory volume were determined in ten healthy volunteers. Using Fowler's single breath nitrogen analyzing technique, atropine was found to increase dead space by 19.2 per cent at one hour, declining to 11.02 per cent at four hours. Glycopyrrolate increased dead space by 21.57 per cent at one hour, 29.28 per cent at two hours, and 26.65 per cent at four hours. When compared to the effects of saline control injection, the dead space increases are significant. The difference between glycopyrrolate and atropine is significant only at four hours. Increases in maximal expiratory flow rate induced by atropine and glycopyrrolate were significant at one-half hour, while atropine alone induced a significant increase in one second forced expiratory volume. Three second forced expiratory volume and total forced expiratory volume were not significantly altered.

Adult↗
PubMed1980

The effect of enflurane and fentanyl anaesthesia on human platelet aggregation in vivo.

In 30 patients undergoing major operations, and anaesthetized with either nitrous oxide, oxygen and enflurane, or nitrous oxide, oxygen and fentanyl, there was no significant alteration in platelet aggregation induced by either adenosine diphosphate or collagen. The absence of any significant effect on platelet function was confirmed by an unchanging thromboelastogram pattern during the study.

Adenosine Diphosphate↗
PubMed1976

Aberrant conduction as a precursor to cardiac arrhythmias during anesthesia for oral surgery.

In 109 patients, it was determined that halothane, when used to anesthetize patients for oral surgical procedures, causes an increased risk of serious cardiac arrhythmias when compared to methoxyflurane and fentanyl/droperidol. It is postulated that this is due to halothane's ability to decrease cardiac conduction and to facilitate the development of reentry phenomena. This decreased conduction may be accentuated by vagal efferent reflexes that have the same effect. The decrease in cardiac conduction was manifested by an ECG pattern of aberrant conduction. This phenomenon was not noted with either methoxyflurane or fentanyl/droperidol.

Adolescent↗
PubMed1975

Post-operative renal failure caused by disseminated intravascular coagulation.

A 22-year-old man suffered a stab wound of the femoral artery and vein. This was followed by disseminated intravascular coagulation. Renal failure then occurred presumably due to fibrin deposition in the small vessels of the kidney. The D.I.C. was successfully treated with heparin and the renal failure with peritoneal dialysis. It is suggested that D.I.C. and consequent alterations in regional blood flow following trauma are not uncommon, and search should be made for these phenomena in every case of major trauma.

Acute Kidney Injury↗