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Biomedical subjects

G N Karachalios

Publications and source records attributed to G N Karachalios.

At least 19 recordsLinked to original sources
PubMed2005

Withdrawal syndrome following cessation of antihypertensive drug therapy.

In this study, a review of the available information concerning abrupt withdrawal of antihypertensive drug therapy is presented. Abrupt withdrawal of these drugs can produce a syndrome of sympathetic overactivity that includes nervousness, tachycardia, headache, agitation and nausea 36-72 h after cessation of the drug. A withdrawal syndrome may occur after discontinuation of almost all types of antihypertensive drugs, but mostly occurs with clonidine, beta-blockers, methyldopa and guanabenz. Less commonly can produce a rapid increase of the blood pressure to pre-treatment levels or above, or both and/or myocardial ischaemia. Although the exact incidence of the syndrome is not known, it appears to be rare, at least in patients receiving standard doses of the above antihypertensive drugs. The best treatment is prevention. In this study regarding the withdrawal syndrome that follows cessation of antihypertensive drugs therapy, a reference to the abrupt discontinuation of the main categories of antihypertensive drugs is also attempted.

Antihypertensive Agents↗
PubMed2005

Consequences of the discontinuation of antihypertensive treatment in successfully treated patients.

Hypertension is probably the most important public health problem in developed countries. Over the last 40 years, an increasing number of hypertensive patients have been treated with various antihypertensive drugs. If the blood pressure (BP) is controlled, the discontinuation of the antihypertensive drug may result either in a relapse of the disease or in the maintenance of normal BP for a long time. In this study, we discuss the available data regarding the consequences of antihypertensive drug withdrawal in successfully treated patients and we suggest guidelines for the application in clinical practice.

Antihypertensive Agents↗
PubMed1998

Prospective randomized study of once-daily versus twice-daily amikacin regimens in patients with systemic infections.

The efficacy and safety of amikacin administered once-daily versus twice-daily was evaluated in adult patients with systemic infections. Patients over 23 years of age with suspected or documented systemic infections were randomly divided into two groups: one group received amikacin intravenously 15 mg/kg once-daily, and the other group received amikacin 15 mg/kg divided into 2 doses. The efficacy of both dosage regimens was very good with a satisfactory clinical response in 90.2% and 89%, respectively. The bacteriological cure rate was 82.2% and 76%, respectively. There were no significant differences between the 2 regimens as far as what efficacy and safety are concerned. Nephrotoxicity appeared in 2 patients of the first group and 3 patients of the second, but did not lead to discontinuation of amikacin. No significant differences between the regimens with regard to hearing loss or prodromal signs of ototoxicity. We concluded that amikacin administered once-daily appears to be as effective and safe as the twice-daily dosing. However, the once-daily administration is more convenient and less costly.

Adult↗
PubMed1996

Treatment of acute biliary tract infections with ofloxacin: a randomized, controlled clinical trial.

The combination of penicillin with an aminoglycoside has been recommended as an initial treatment of choice for patients with acute infections of the biliary tract. However, many patients have incidence of renal problems and for this reason aminoglycosides must be avoided. Newer antimicrobial agents with lesser nephrotoxic effects will be tried. We, therefore, performed a prospective, randomized trial of ofloxacin, a new quinolone and ceftriaxone in patients with acute biliary tract infections. Fifty-two patients with severe biliary tract infections (cholecystitis and cholangitis) were randomly assigned to receive either ofloxacin (n = 28) or ceftriaxone (n = 24). The 2 groups receiving antibiotics were similar with respect to all clinical and laboratory parameters. Bacteria were documented in 48% of patients in the ofloxacin group and in 46% in the ceftriaxone group. The percentage of patients with a clinical cure or significant improvement was the same in the 2 groups. No significant difference was noted between the 2 treatment groups with respect to drug toxicity. These data suggest that intravenous ofloxacin followed by oral administration is an effective and safe single drug for the therapy of patients with acute biliary tract infections.

Anti-Infective Agents↗
PubMed1992

Treatment of acute migraine attack with diclofenac sodium: a double-blind study.

The efficacy of diclofenac sodium, a potent prostaglandin inhibitor, in patients with acute migraine attacks in a double-blind placebo-controlled study involving 86 migraine patients. Forty-six patients with acute migraine attacks were treated with intramuscular injection of 75 mg diclofenac sodium, and another group of forty patients with intramuscular injection of paracetamol. Partial or complete relief of pain and other symptoms of acute migraine attack was achieved within 10 minutes after treatment in the diclofenac sodium group and within 32 minutes in the paracetamol group. Complete relief of attack was achieved within 30 minutes after diclofenac sodium in 40 patients (88%) compared to 7 patients (17.5%) of the paracetamol group (P less than 0.001). Five of the patients treated with diclofenac sodium needed a second injection for complete relief of pain during the 2-to-4 hour follow-up period. Side effects were rare and minimal. In conclusion, diclofenac sodium administered intramuscularly is a very effective drug in treating acute migraine attacks.

Acetaminophen↗
PubMed1991

Treatment of acute pyelonephritis in women with intramuscular ceftriaxone: an out-patient study.

Ceftriaxone, a third-generation cephalosporin with a long half-life, was administered intramuscularly to 30 adult women suffering from acute pyelonephritis. Standard bacteriologic methods were used to identify the pathogens and their susceptibilities before treatment and at intervals during and after treatment. Overall cure was achieved in 25 (85%) of the patients 6 weeks after completion of therapy. The results demonstrate that ceftriaxone is an effective drug when given once a day intramuscularly to out-patients with acute pyelonephritis.

Acute Disease↗
PubMed1991

Value of single-dose ciprofloxacin in the treatment of acute uncomplicated urinary tract infection in women.

Single-dose antibiotic therapy for uncomplicated infection of the lower urinary tract (UTI) in women has resulted in high success rates. Ciprofloxacin, like other new quinolones, has shown good in vitro activity against the pathogens most frequently encountered in UTI, high concentrations in the urine and is well tolerated. The present report describes a randomized, double-blind, controlled trial of two single-dose regimens of ciprofloxacin in women with lower UTI. Thirty-six women received 250 mg and forty-two received 500 mg of ciprofloxacin as a single dose. Escherichia coli was the most frequently isolated pathogen in both groups (forty-eight patients). Clinical and bacteriological cures were attained in 81% and 93% of the 250 mg and 500 mg dose groups, respectively, 7 days after treatment. Follow-up at 4 weeks after completion of treatment disclosed that the clinical cure rate was 62% and 79% respectively. Ciprofloxacin was well tolerated. This study shows that a single dose of ciprofloxacin is an effective and safe treatment of uncomplicated UTI. Although the cure rates were higher with a single dose of 500 mg, further studies are needed for assessment to determine the optimal dose.

Acute Disease↗
PubMed1989

Treatment of various infections in an outpatient practice by intramuscular ceftriaxone: home parenteral therapy.

Ceftriaxone, a broad-spectrum third-generation cephalosporin with a long half-life, was administered intramuscularly to 23 outpatients who had a variety of infectious diseases. Cure was achieved in 21 of the patients (91%). The results of this study indicate that ceftriaxone is an effective and well-tolerated antimicrobial agent when administered intramuscularly to outpatients with various infections.

Adult↗
PubMed1988

Treatment of hypertensive emergencies with nifedipine.

The effects and safety of using sublingually nifedipine 10-20 mg as acute antihypertensive treatment were evaluated in 108 patients with hypertensive emergencies or urgency without intensive care monitoring. Before treatment, mean systolic blood pressure was 220 +/- 28 mmHg, mean diastolic blood pressure was 125 +/- 15 mmHg and mean arterial pressure was 155 +/- 14 mmHg. Administration of 10 mg of sublingual nifedipine reduced the blood pressure within 10 min and produced a peak effect level between 30 to 40 min. Blood pressure decreased significantly to a mean 155 +/- 20 and 92 +/- 14 mmHg systolic and diastolic blood pressure, respectively. Minimal adverse effects was observed. Five patients, required additional therapy with other antihypertensive drugs. Heart rate increased from 74 +/- 10 to 84 +/- 10 beats per min. The response to nifedipine correlated with the blood pressure value prior to treatment, but did not correlate with age or the type of hypertensive emergency. These results indicate that nifedipine administered sublingually is a simple, effective, and safe agent for treating hypertensive emergencies, especially for the patients in whom intensive care monitoring cannot be guaranteed.

Administration, Sublingual↗
PubMed1987

Norfloxacin versus nalidixic acid in the treatment of urinary tract infections.

Norfloxacin (MK-0366), a new oral quinoline antimicrobial agent, was shown to have much wider spectrum than nalidixic acid which includes Pseudomonas aeruginosa and gram-positive cocci. Many studies have been undertaken to determine the clinical effectiveness of norfloxacin in patients with urinary tract infections. Seventy-two patients with urinary tract infections caused by sensitivity strains were treated with either 400 mg norfloxacin per 12 hours or nalidixic acid 500 mg every 8 hours for 7 days. Follow-up examinations showed that norfloxacin is more effective than nalidixic acid, 93% and 83%, respectively, for the eradication of bacteriuria and symptoms. Adverse reactions due to norfloxacin were fewer and minor, and the tolerability seemed to be better than that of nalidixic acid.

Adult↗
PubMed1986

Hypertensive emergencies treated with oral clonidine.

Thirty-eight severely hypertensive patients were treated with oral clonidine. Each patient received a "loading" dose of 0.2 mg clonidine, followed by 0.1 mg hourly until the blood pressure was substantially reduced, or until a total dose of 0.8 mg has been administered. Thirty-five (82.1%) patients responded favourably, with a reduction in the systolic blood pressure in the supine position from 210 +/- 20 to 145 +/- 20 and to 98 +/- 15 mmHg diastolic after 6 hours. The average dose of clonidine was 0.5 mg. Side-effects were minimal. The study has shown that oral clonidine given in a "loading" dose is safe and effective in the management of patients with hypertensive emergencies, and it may have an advantage over other antihypertensive drugs administered parenterally.

Adult↗
PubMed1985

Randomized comparative study of amoxicillin-clavulanic acid and co-trimoxazole in the treatment of acute urinary tract infections in adults.

The efficacy and safety of amoxicillin-clavulanic acid were compared with those of co-trimoxazole in the treatment of acute urinary tract infections. A total of 104 patients (mean age, 52 years) with clinical and laboratory evidence of acute urinary tract infection were enrolled in the study. Characteristics and infecting organisms were equivalent in both groups of patients. Escherichia coli was the predominant bacteria pathogen in both groups. Both drugs resulted in clinical improvement in 100% of the patients; bacteriological cure after the termination of therapy was 95% with amoxicillin-clavulanic acid and 83% with co-trimoxazole (P less than 0.001). Side effects were not severe enough to necessitate discontinuation of the antimicrobial agents. Amoxicillin-clavulanic acid is effective and safe therapy for acute urinary tract infections caused by susceptible bacteria.

Acute Disease↗
PubMed1985

Treatment of respiratory tract infections with a combination of amoxycillin and clavulanic acid.

Forty-four patients with respiratory tract infections were treated using a new formulation of amoxycillin and clavulanic acid. Clinical diagnosis was classified as follows: 19 cases of acute exacerbations of chronic bronchitis, 10 cases of bronchiectasis, and 15 cases of diffuse or localized pneumonia. Amoxycillin/clavulanic acid combination (amoxycillin 250 mg + clavulanic acid 125 mg per tablet) was administered as 2 tablets three times per day for 7-14 days. The efficacy was as follows: chronic bronchitis 94.7%, bronchiectasis 80.0% and pneumonia 93.3%. No severe adverse reactions occurred in treated patients and no renal, hepatic or hematological toxicity was observed. Amoxycillin/clavulanic acid combination was a safe and effective antimicrobial agent for the treatment of respiratory tract infections.

Adult↗
PubMed1984

Acute renal failure in acute pancreatitis.

Nine patients who developed acute renal failure in the course of acute pancreatitis are described. All patients developed acute renal failure in the absence of hypotension. Acute renal failure developed within 24 to 72 hours after admission. They were treated conservatively except for one, who was treated with peritoneal dialysis. The duration of the oliguric phase of acute renal failure subsided between 4 to 14 days, and all patients recovered from both acute pancreatitis and acute renal failure.

Acute Disease↗