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Biomedical subjects

E Schnurr

Publications and source records attributed to E Schnurr.

At least 19 recordsLinked to original sources
PubMed1992

Pharmacokinetics and first clinical experiences with an antihypertensive dopamine (DA2) agonist.

The pharmacokinetic properties and first clinical experiences with the antihypertensive dopamine (DA2) agonist, carmoxirole, are summarized. In man carmoxirole was rapidly absorbed. On oral administration the maximum plasma concentration was reached after 2-3 h. The drug was metabolized, mainly to an ester-type glucuronide, and was excreted (unchanged carmoxirole plus glucuronide) largely by the kidneys. The plasma half-life of the parent compound was 5.5 h. For the dose range tested (0.5 to 1.5 mg) the pharmacokinetics were linear. The drug was rapidly distributed in animals but only very small amounts penetrated the blood-brain barrier. Carmoxirole did not affect supine blood pressure in healthy subjects, but under the conditions of the Schellong's test some orthostatic reactions occurred with high doses. In patients the blood pressure was reduced for at least 8 h after single oral doses. On repeated administration for several weeks a relevant antihypertensive effect was still measurable 12 and 24 h after dose. The most frequently reported adverse events have been headache, dizziness, tiredness, nausea, and gastric disorders. These symptoms are considered to be mainly due to blood pressure reduction, as is frequently observed at the beginning of antihypertensive therapy. In patients the incidence of orthostatic reactions is appreciably lower than in healthy subjects, and in both change of position was sufficient to relieve the symptoms.

Administration, Oral↗
PubMed1987

Efficacy and safety of carvedilol in the treatment of hypertension.

In an open clinical study, long-term efficacy and safety of carvedilol were investigated in 154 patients with essential hypertension WHO I-II and diastolic blood pressure (BP) between 95 and 115 mm Hg over a period of 1 year. After a washout and a placebo phase, all patients were treated with 25 mg carvedilol b.i.d., after 4 weeks of an adaption to 25 mg o.d. or 50 mg b.i.d. was possible. Eighty-six patients had been treated according to the protocol (5 patients 25 mg o.d., 77 patients 25 mg b.i.d., and 4 patients 50 mg b.i.d.) An additional 18 patients were included to the final evaluation in spite of the fact that they had incorrect placebo phases. Ten patients had to be excluded from the final evaluation because of protocol violation. Eight patients dropped out because they were nonresponders, 8 patients dropped out because of side effects, and 15 patients dropped out because of other reasons. In all patients treated over the period of 1 year, 99 patients had a diastolic BP less than or equal to 95 and 88 of the less than or equal to 90 mm Hg. The side effects were mostly correlated to the pharmacodynamic effects of the drug; there were no serious side effects during the trial.

Administration, Oral↗
PubMed1979

Changes of electrolyte excretion, renin activity, angiotensin-II and aldosterone concentrations during administration of 3-amino-1-(3,4-dichloro-a-methyl-benzyl)-2-pyrazolin-5-one (Bay g 2821).

After the administration of 40 mg Bay g 2821, a new potent diuretic substance, a significant increase of sodium and water diuresis occurred. There was only a short rise in potassium excretion. In contrast to the sodium and water diuresis no significant increase of renin-activity, angiotensin-II or aldosterone concentration was seen. In spite of the insignificant stimulation of the renin-angiotensin-aldosterone system, a significant increase of correlation occurred between the three components of the renin-angiotensin-aldosterone system.

Adult↗
PubMed1978

[CSF lactate and EEG changes in comatose patients with various medical conditions (author's transl)].

EEGs were recorded and initial CSF and blood lactate measurements (135) made in 104 patients who were in coma of differing severity from a variety of medical conditions. There were two patterns: in one, the CSF lactate alone was due to cerebral tissue hypoxia; and in the other factors, such as cerebral haemorrhage, meningitis or lactacidosis were predominantly present. In those with cerebral hypoxia there was a connection between the severity of the disease picture and the level of CSF lactate. In extreme cases with dissociated cerebral death, there was a mean CSF lactate concentration of 11.78 +/- 1.66 mmol/1. The prognosis of coma with concentrations above 9 mmol/l is, therefore, poor if not hopeless. To some extent one may draw prognostic conclusions from lower concentrations but this is not possible in individual cases. There was no definite correlation between the severity of EEG changes and the level of CSF lactate in coma, although there was some relationship to the degree of cerebral hypoxia. In case of meningitis, CSF lactate allowed differentiation between bacterial and viral cause, the average concentration in the former being four times normal.

Acidosis↗
PubMed1977

[Haemodialysis in diabetics with terminal renal failure].

Long-term dialysis treatment of diabetics with terminal renal failure is beset with severe complications. In 19 unselected diabetics in terminal renal failure (13 juvenile diabetics and 6 maturity-onset diabetics) the clinical course during long-term dialysis was observed. A total of 1377 dialyses during 167 months of treatment were performed. Diabetic angiopathy, hypertension, and hyperhydration were the most prominent complications. The interval between the onset of diabetes and the beginning of dialysis treatment was 21,5 years in the juvenile diabetics and 5,2 years in maturity-onset diabetes. The survival time during dialysis was on average 13,2 months for the juvenile diabetics and 0,6 months for maturity-onset diabetics. The patients died chiefly from cardiovascular complications.

Adolescent↗
PubMed1977

Clearance and dialysance of 3H-aldosterone in vitro.

Using an "in vitro dialysis" with different dialyzers, a significant decrease in 3H-aldosterone concentration was seen. From the decrease of 3H aldosterone elimination parameters were calculated. Half time of elimination was 21,5 min, the mean clearance of all dialyzers averaged 32.2 ml/min. The dialysances of 3H aldosterone evaluated with dialyzers of different surface areas were correlated with the surface areas of the dialyzers. From the results can be concluded, that besides individual influences of regulation, haemodialysis influences aldosterone concentration in plasma by physical factors.

Aldosterone↗
PubMed1977

[The value of stimulation of the renin-angiotensin-aldosterone system as a screening test for hypertension (author's transl)].

Renin activity, angiotensin-II concentration and venous aldosterone concentration were measured in 20 healthy subjects and 18 hypertensives before and after stimulation of the renin-angiotensin-aldosterone system. The test did not distinguish between the two groups: in the individual case there was no relationship between renin-activity, angiotensin-II concentration and aldosterone concentration in peripheral venous blood. Stimulation of the system without sodium balance is not a reliable screening test for hypertension.

Adult↗
PubMed1976

[Plasma aldosterone during haemodialysis in patients with terminal renal failure].

In 14 patients with terminal renal failure who underwent dialysis with a solution containing potassium in a concentration of 2 mmol/l, the aldosterone concentration in plasma decreased significantly during haemodialysis. On the other hand a clear increase of plasma aldosterone was observed during haemodialysis in two patients who were dialysed with a solution containing potassium in a concentration of 4 mmol/l. This observation demonstrates the importance of plasma potassium for the regulation of plasma aldosterone concentration during haemodialysis. It suggests that the renin-angiotensin system has no major role in the regulation of aldosterone despite sodium and fluid losses.

Aldosterone↗
PubMed1976

[Treatment of severe hypnotic poisoning with extracorporeal haemoperfusion (author's transl)].

Four patients with severe hypnotic intoxication, twice after suicidal intake of barbital, once of barbital, methaqualone and carbromal, and once of carbromal, were treated with six activated charcoal haemoperfusions. Three patients showed rapid improvement in the level of consciousness followed by complete recovery. One female patient died in cerebral coma due to complete acute cerebromalacia following hypoxia. Serious complications due to the haemoperfusion did not occur. Correct use of activated charcoal haemoperfusion enriches the therapeutic spectrum of severe exogenous intoxications.

Adult↗