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Biomedical subjects

D Zaske

Publications and source records attributed to D Zaske.

9 recordsLinked to original sources
PubMed1991

Comparison of pharmacokinetic and safety profiles of amantadine 50- and 100-mg daily doses in elderly nursing home residents.

Pharmacokinetic and adverse event profiles of 50- and 100-mg amantadine doses administered daily for up to 21 days for influenza prophylaxis were compared in 82 elderly nursing home residents (mean age 85 yrs, 68% female). We sought to determine if a standard daily dose of 50 mg would achieve mean steady-state trough serum concentrations (CPSSt) of 300 ng/ml and be associated with a lower frequency of adverse events than 100-mg doses. Statistically significant relationships were found between CPSSt and dosage (in mg/kg/day) and serum creatinine. Adverse events were more common with the 100-mg dose (24% vs 14%); 94% occurred in women. Amantadine CPSSt and apparent clearance were not significantly different between sexes. Thirty-nine residents (89%) receiving 50 mg daily achieved CPSSt below 300 ng/ml compared to 42% receiving 100 mg. Standard daily amantadine doses of 50 mg may not achieve adequate CPSSt in elderly nursing home residents, but 100 mg may lead to excessive CPSSt and adverse events, especially in the presence of renal impairment.

Aged↗
PubMed1989

Inline fluid dynamics in piggyback and manifold drug delivery systems.

Inline mixing characteristics of primary and secondary i.v. solutions were evaluated for the piggyback and manifold systems. Dextrose (5%) and sodium chloride (0.9%) were used as markers for the primary and secondary solutions, respectively. With a 120-mL/hr flow rate, samples (up to 180) were collected over 36 minutes to quantify the change in concentration of each marker when the primary solution was changed to the secondary solution (phase 1) and when the secondary solution was changed to the primary solution (phase 2). The relative concentration data for each marker were fitted to a Weibull mathematical model to describe the disappearance and appearance of the two solutions over time. These data were then used to calculate the volume of secondary solution that was mixed with the primary solution in phases 1 and 2. With the piggyback system, the total mixing volume was 13.5 mL, with 11.1 mL contributed by the secondary solution (phase 1). In phase 2, the total mixing volume decreased to 6.6 mL, with 2.0 mL contributed by the secondary solution. The mixing volumes for the manifold system were markedly reduced; 5.8 mL of the secondary solution became mixed with 1.9 mL of the primary solution. The total mixing volume during phase 1 was reduced from 13.5 to 5.6 mL. The mixing volumes for the primary, secondary, and total solutions in phase 2 were comparable to those with the piggyback system. The use of manual clamps or automated line closures as part of a manifold system can substantially reduce the mixing of solutions inline, compared with a piggyback system.

Drug Therapy, Combination↗
PubMed1979

Ecthyma gangrenosum: survival with individualized antibiotic therapy.

Five burn patients with ecthyma gangrenosum were treated with gentamicin sulfate in an individualized aminoglycoside regimen. Dosages greater than the currently recommended 3 to 5 mg/kg/day were necessary and ranged from 15 to 30 mg/kg/day. These increased dosages cannot be used routinely but only as serum level data indicate the need. Four of the five patients survived their course of ecthyma gangrenosum. The single fatality received a much smaller dosage of gentamicin as compared with the other four patients. No ototoxic or nephrotoxic reactions were noted in any of the patients.

Adolescent↗
PubMed1979

Individualizing gentamicin dosage regimens in burn patients with gram-negative septicemia: a cost--benefit analysis.

Services provided by a clinical pharmacokinetics laboratory were evaluated in terms of an accepted cost--benefit model, and a model to evaluate clinical services provided by the pharmacist is presented. A retrospective study was conducted to evaluate the impact, in terms of patient outcomes, of individualizing gentamicin dosage regimens in severely burned patients. Analysis was conducted using multivariate statistical techniques and appropriate nonparametric and parametric tests to determine significant differences. This analysis provided the necessary data to quantify the impact of the pharmacokinetic service. The findings suggest that significant differences do exist in comparing individually dosed patients against those who were not, based upon discriminant and multiple regression analyses and/or nonparametric tests. Furthermore, the results will be useful for insurance companies, third-party payers, and government agencies in deciding which innovative clinical services should be reimbursed.

Burns↗
PubMed1979

Comparative study of cefaclor and amoxicillin in treatment of urinary tract infection.

Cefaclor or amoxicillin was given to 51 randomly assigned patients with urinary tract infections. Inclusion in the study required two pretreatment urine cultures yielding the same organism (susceptible to both antibiotics) in concentrations greater than or equal to 10(5)/ml. Both drugs were administered as 250 mg. orally every eight hours for ten days. Cefaclor was given to 27 patients and amoxicillin to 24. Most patients in both groups had negative urine cultures at five to nine days and four to six weeks following therapy. One patient in each group was unsuccessfully treated. Relapse or reinfection occurred with similar frequency in both treatment groups. Both antibiotics were well tolerated. minimal inhibiting concentrations (MICS) of cefaclor, amoxicillin, cephradine, and cephalexin were determined by an agar dilution technique for the 44 available pretreatment isolates (41 Escherichia coli and 3 Proteus mirabilis). Mean MICs (micrograms./ml., +/- SD) were 2.2 +/- 1.4 for cefaclor, 4.4 +/- 2.0 with amoxicillin, 8.1 +/- 4.2 for cephradine, and 5.7 +/- 3.0 with cephalexin. Cefaclor is highly active in vitro against those gram-negative bacteria which are commonly isolated from urine. Cefaclor is as effective as amoxicillin when administered three times daily for the treatment of urinary tract infection.

Amoxicillin↗
PubMed1979

An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies.

Studies to determine the epidemiologic behavior of strains of Staphylococcus aureus resistant to methicillin and aminoglycosides (MARS) were conducted over a period of two and one-half years, during which MARS were isolated from 201 patients at a hospital in the midwestern United States. Most cases of infection or colonization with MARS (156 of 201) occurred in patients with burns. In the burn unit, MARS were recovered from the air, from the hair and hands of personnel, and from inanimate objects. Nasal (72%) and rectal (66%) colonization were common among burned patients with infected or colonized burn wounds but occurred in only six of 74 burn unit personnel. When compared with two control periods, the prophylactic use of antistaphylococcal agents in patients with burns increased markedly at the time the outbreak began. Of the 45 patients without burns from whom MARS were isolated, 42 (93%) were surgical patients. MARS were not demonstrated in the air or environment of patients with infected surgical wounds. None of 334 non-burn unit hospital personnel were found to be carriers of MARS. Four phage types (83A, 6/75/85, 29/52/80, and 92) were recovered during the outbreak. A determinant of antibiotic resistance was probably transmitted among strains of S. aureus.

Aminoglycosides↗
PubMed1979

Phenobarbital dosage for control of neonatal seizures.

The relationship of the initial phenobarbital dose to weight, gestational age, blood level, and seizure control was studied in 39 neonates. The blood proportional to the dosage per kilogram, and was not related to weight or gestational age. Seizures remitted only at blood phenobarbital concentrations above 16.9 micrograms per milliliter. Therapeutic levels can be achieved by the intravenous or intramuscular administration of 16 to 23 mg per kilogram of phenobarbital.

Humans↗
PubMed1976

Anaphylactic shock following oral penicillin--report of two cases.

Two cases of anaphylactic shock secondary to oral penicillin therapy are presented. The clinical course and treatment of the two patients are discussed. Ways in which physicians and pharmacists may reduce the incidence and severity of anaphylactic reactions to penicillin are reviewed.

Anaphylaxis↗