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Biomedical subjects

G D Doyle

Publications and source records attributed to G D Doyle.

At least 37 records · Page 2Linked to original sources

Pharmacokinetics of ticarcillin and clavulanic acid (timentin) in relation to renal function.

The disposition of coadministered ticarcillin (3 g/1.73 m2) and clavulanic acid (100 mg/1.73 m2) was examined after a 30-min infusion in 24 noninfected subjects with various degrees of renal function. Noncompartmental pharmacokinetic parameters for the individual compounds were determined from plasma concentrations and urinary excretion rates. All clearances (total, renal, and nonrenal) and urinary recoveries of unchanged drug were found to be linearly related to creatinine clearance (CLCR). The steady-state volume of distribution (9.9 and 12.9 liters for ticarcillin and clavulanic acid) approximated the extracellular fluid space and was not related to CLCR. The half-lives increased with reduced renal function and ranged from 56 to 392 min for ticarcillin and 26 to 266 min for clavulanic acid. The clearances of both drugs decreased proportionately with reduction in renal function, facilitating dosing adjustments based on CLCR. Calculations of expected steady-state maximum and minimum concentrations in plasma using constant doses and an extended dosing interval related to CLCR further rationalized use of the 30:1 drug combination ratio for all patients.

Adolescent↗

Enalapril in the treatment of hypertension associated with impaired renal function.

This pilot study was undertaken to examine the safety and efficacy of enalapril in the treatment of hypertension associated with impaired renal function. Forty-one patients with glomerular filtration rate (GFR) < or = 50 ml/min received enalapril for up 12 weeks. Blood pressure, renal function, biochemistry and haematology were monitored weekly for 4 weeks and then monthly. Blood pressure was effectively reduced within 4 weeks; this reduction was maintained for at least 12 weeks. Renal function remained stable and there was no significant sustained alteration in any biochemical or haematological parameter. Requirement for additional antihypertensive drugs was reduced during enalapril therapy. These data suggest that enalapril may have a useful role in the management of hypertension associated with renal impairment.

Adult↗

The prevalence and significance of gastritis in patients with lower intestinal irritable bowel (irritable colon) syndrome.

Histological gastritis was present in nearly two-thirds of consecutive patients with lower intestinal irritable bowel (irritable colon) syndrome. The presence of gastritis had no relationship to upper intestinal symptoms; we believe that upper intestinal symptoms in these patients are therefore unlikely to be due to coexistent gastritis. Abnormal pyloroduodenal motility with consequent abnormal bile reflux or clearance may account for gastritis in patients with irritable colon. This study, admittedly uncontrolled, provides further indirect evidence to support the concept of a widespread neuromuscular abnormality throughout the gastrointestinal tract in irritable bowel syndrome patients who have predominantly colonic symptoms.

Adolescent↗

The diagnostic necessity of liver biopsy in drug abusers with normal liver function tests.

Forty-six of sixty-one drug abusers admitted for detoxification had liver biopsies. Nineteen biopsied patients had normal liver function tests. Of these, two had chronic active hepatitis; nine had chronic persistent hepatitis; six including three with fatty changes, had minor changes, and only two had normal liver histology. Chronic active hepatitis was found only in those with persistent HBS antigenaemia. Chronic persistent hepatitis was found in four patients who were negative HBS antigen and antibody, and in four patients who had cleared HBSAg. In parenteral drug abusers with normal liver function tests the absence of persistent HBS antigenaemia does not rule out chronic liver disease: liver biopsy is necessary for accurate assessment of liver status.

Biopsy↗