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H Iwainsky

Publications and source records attributed to H Iwainsky.

At least 19 recordsLinked to original sources
PubMed1991

[Clinical pharmacology in optimization of therapy of lung diseases].

The optimization of the therapy of lung tuberculosis and asthma bronchiale was supported since 1955 by clinical-pharmacological investigations. The prerequisites therefore--using highly specific methods of distribution and quantification in biological material till to the synthesis of 3H-INH and 3H-RMP were introduced step by step. The investigations--in most cases estimations of the nonbiotransformated part of antituberculotic drugs and theophylline had following purposes: security of the necessary dose especially in the case of INH (hereditary INH-polymorphismus), proof of a sufficient permeation of INH and RMP in the tuberculous kidney, control of the usefulness or uselessness of the INH-depot-preparations, relations between the concentration in the serum and dose respectively of the appearance of side effects, estimation of bioavailability and pharmacokinetic parameters during the development of an useful retard-preparation of theophylline.

Antitubercular Agents↗
PubMed1988

[Theophylline-retard preparations: relation between drug liberation in vitro and their behavior in the human body].

Using theophylline retard preparations, the course of drug concentration in serum can be read from the speed of drug liberation estimated in vitro. For preparations with a strong retard effect we have to calculate a diminished bioavailability. The management of therapy in the therapeutical range and without side effects is possible with preparations with nearly complete bioavailability, nevertheless theophylline remains a problem drug. Firstly, the interindividual deviations are excessive great, with the usual standard dose caused by the different body mass and by the different biotransformation. Secondly, the "Food induced dose dumping" is appearing if taking drug and food is unsuitably coupled. Summarizing the present results, several steps for further optimization of therapy with theophylline retard preparations are proposed.

Administration, Oral↗
PubMed1987

[Pharmacokinetic and therapeutic monitoring in the development of theophylline-retard preparations].

After oral application of a sustained release preparation of aminophylline (2 tabl. of 350 mg b. i. d., i. e. a total doses of 1400 mg) the doses related to body mass and the average individual concentration of theophylline in serum are varying about 50% and more of the mean. The mean individual concentration in serum changes proportionally to the doses related to body mass. Furthermore two groups of patients with different theophylline concentrations can be distinguished. The reason is probably a different biotransformation. The mean concentration of theophylline in serum rises to a maximum at the 5th d. From the 8th to the 29th d of treatment the range of concentration is nearly constant. Reaching the steady state is probably overlapped by processes of enzyme induction. In about 60% of the patients the concentrations of theophylline are in the therapeutical range. When adaptation of doses to body mass takes place a higher portion can be expected. To achieve all therapeutical possibilities it is necessary to correct the doses also for the different types of biotransformation.

Biotransformation↗
PubMed1986

[Monitoring of medication in optimalization of preoral theophylline in long-term care].

A narrow therapeutic index, considerable interpatients variability of clearance and biotransformation, rapid alterations of pharmacokinetics point out theophylline to a problem-drug. An effective long-term treatment with this drug is only possible with retard-preparations. For a certain therapy a drug monitoring-controlling the theophylline-concentration in the serum--is necessary, in what extend and under which conditions is discussed in detail.

Delayed-Action Preparations↗
PubMed1986

[Effect and side effects of a depot theophylline preparation within the scope of a clinical trial].

Effects and side effects of the Aminophylline-retard-preparation V 37 are studied during a four week period of monotherapy on 50 patients suffering from obstructive lung disease. Treating with a standard dosis (2 X 700 mg daily) the concentrations of Theophylline in serum were in the therapeutical range in 50% of patients. A dosis correction was not proposed. Therefore 9 patients have to be excluded from the trial (5 unsufficient effects, 4 unreasonable side effects). Two further patients must be excluded because of an acute exacerbation of their disease. An optimization of therapy is possible by a stepwise increase of the dosis and by an adaptation of the dosis considering the body weight, the effects (estimating the FEV1) and the side effects. Clinical aspects are more relevant for dosis correction than the estimation of the Theophylline concentration in serum. Its measurement should be performed in special cases.

Aminophylline↗
PubMed1985

[The pharmacokinetics of rifampicin in the intermittent treatment of patients with pulmonary tuberculosis. 1. Excretion of rifampicin in the urine].

With a rifampicin (RMP) range of 600 to 1800 mg, 12.5% of the administered dose are on an average secreted in urine. In spite of this minimal portion the course of pharmacokinetic processes can distinctly be learned from its alterations. Analyses in 84 patients revealed that the age will influence the induction and the sex-specific differences of the pharmacokinetics. Compared to male subjects, an increased RMP secretion in urine can be recorded in young female subjects, whereas in older male ones an induction-reduced RMP elimination in urine becomes more obviously. Considering these multiform processes, the determination of the bioavailability of RMP preparations by means of the RMP secretion in urine is taken to be manipulatable and uncertainly. More evident results can be gained by the determination of the RMP concentration in serum or by the calculation of the AUC.

Adult↗
PubMed1985

[Bronchoalveolar lavage].

The incidence of interstitial lung diseases is increased during the last years. A possibility for improvement the diagnosis of these lung diseases is the bronchoalveolar lavage (BAL). In a critical review the performance of the BAL, same properties of the isolated macrophages and the determination of biochemical parameters in lavage fluid are described. In this context especially problems of diagnosis of sarcoidosis are discussed. There are new fields of application of BAL (diagnosis of occupational lung diseases, control of therapy). In order to improve the comparability of different results a standardization of BAL is necessary.

Carbohydrate Metabolism↗
PubMed1985

[Clinico-experimental studies of therapy optimization in kidney tuberculosis].

The use of antituberculotic short-term chemotherapeutic methods did not yet make its way on a larger scale in the treatment of the extrapulmonary tuberculosis on account of supposed peculiarities of the terrain. Therefore, the present clinical and experimental study had the aim to investigate the distribution of INH and RMP in the kidney and the radiometrical determination of their concentration directly in the tuberculous focus of the kidney. For this purpose the tritium labelling of the two basis antituberculotics mentioned was carried out. Apart from the description of the applied working and measuring technique, questions of the distribution of medicaments are discussed. The results made evident that also in kidneys widely destroyed by tuberculosis both INH after an intravenous application of 300 mg and RMP after oral application of 600 mg even in large tuberculous caverns achieve antimycobacterially effective concentrations. Indeed, there are considerable differences, however, the values were always far above the minimum inhibition concentration. Thus there are no terrain-caused peculiarities for the tuberculous kidney and also no restrictions as to the use of an optimized antituberculotic chemotherapy. The same is probably also applied to all other forms of the extrapulmonary tuberculosis. The newly developed method distinguishes itself by a high measuring exactness and could analogously be used in questions of the chemotherapy of malignant tumours.

Adult↗
PubMed1984

[Possibilities for optimizing therapy with theophylline preparations. Clinical effectiveness and side effects of microcrystalline theophylline].

The efficacy of microcrystalline theophylline is examined in patients with stabilized bronchial asthma. Beside the concentration of theophylline in the serum are estimated: the changes of subjective state of health, the consumption of beta2-stimulants, VC and FEV1. Although in 8 of 10 patients the theophylline concentration in the serum was below the therapeutical range for a considerable period of time, an improvement of the subjectively estimated state of health, a diminished consumption of beta2-stimulants and an increasing VC and FEV1 are evident after 6-7 days, also statistically confirmed. Proposals are suggested for using all possibilities for an improved therapy with theophylline.

Adult↗
PubMed1984

[Possibilities for optimizing therapy with theophylline preparations. III. Ventilatory effect and pharmacokinetics of "new" Pulmophyllin].

Investigations comparing the preparations Pulmophylline "new", Pulmophylline and Aminophylline show that Pulmophylline "new" has a position between the two other drugs concerning the ventilatory effect and the pharmacokinetics. The effect of this preparation starts in a slower rate and lasts longer than that of Pulmophylline, the effect decreases in a quicker manner than that of Aminophylline. Replacement of the Ethoxytheophylline by the more efficient Theophylline seems to be the first step for the optimization of this drug-preparation. The diminished rate of side effects of Ethoxytheophylline is connected with an unfavourable pharmacokinetics and a smaller effect, as it is shown by investigations of other authors and by our own results.

Adult↗
PubMed1984

[Possibilities for optimizing therapy with theophylline preparations. I. On the pharmacokinetics of theophylline preparations].

In the treatment of obstructive lung diseases theophylline is one of the most important drugs. But its therapeutic range is narrow, therefore attempts are made for an optimal therapy (dosage adjusted to the theophylline concentration in the serum, treatment with microcrystalline theophylline or retard preparations). Pharmacokinetic studies are undertaken with two theophylline formulations commercially available and the commonly used aminophylline to achieve the optimal therapeutic benefit. Regarding the results Aminophylline retard belongs to the formulations with diminished bioavailability and is therefore not satisfactorily qualified for an optimal treatment. On the other hand the development of a formulation of microcrystalline theophylline like Bronkodyl promises advantages for the long-continued treatment of obstructive lung diseases because of the smaller differences of the individual pharmacokinetic values from the median values.

Adult↗
PubMed1981

[The stability of drugs under the conditions of the ultrasonic thermo aerosol (author's transl)].

Under conditions of the ultrasonic thermo aerosol the stability of selected drugs is investigated by estimation of their concentration and by spectrophotometric and thin-layer chromatographic analysis, respectively. Using an ultrasonic nebulizer USI 50 of the common production neither the spectrophotometric nor the thin-layer chromatographic analysis give any sign of destruction processes of the drugs used. As a rule the concentration of the drugs is lower in the condensed aerosol than in the stock solution. For clinical use this decrease in unimportant. Producing the stock solution of nystatin corresponding to the recommendations of the committee "Aerosols in the Medicine" of the Society of Bronchopneumonology and Tuberculosis of the GDR, only very low concentrations of nystatin can be detected in the aerosol. Producing the solution in another way--chosen by us--50% of the concentration in the stock solution can be fund in the aerosol. But this manner of production still needs the approval of the central expert evidence committee.

Aerosols↗
PubMed1981

[Application of theophylline as an inhalant (author's transl)].

The local tolerance and the functional efficacy of theophylline inhalant were investigated in 51 patients suffering from NSLD with reversible bronchospasm. In different doses aethophylline and aminophylline were nebulized using a jet or an ultrasonic nebulizer. FEV1 was controlled in fixed intervals and the patients were questioned about their subjective statements. At the end, a test with novodrin (isoprenaline)-spray was performed demonstrating the actual reversibility of the bronchospasm. In conclusion of our findings we can state: 1. Theophylline aerosols produced by a jet have neither an important subjective nor a functional efficacy. A prolongation of the inhalation time and the nebulized dose, respectively, has no better effects. 2. Aerosols of a 5% solution of theophylline produced by an ultrasonic nebulizer caused intensive local side-effects. Contrary to these aerosols those of a 2.5% solution were proved to be better tolerable and functionally effective, too, but only on patients with reversible bronchospasm. 3. Subjective statements and functional parameters were in a good accordance. 4. Serum levels of theophylline are not detectable with the method of SCHACK and WAXLER. The positive ventilatory effects after inhalation may suggest a topical action of the inhaled theophylline on the mucous membrane in the bronchial tree. 5. The increased values of FEV1 after the inhalation of theophylline are further increasing after the test with novodrin-spray. Therefore investigations of combination of theophylline and beta 2-sympathicomimetics in an aerosol seem usefully for optimization of the effect and for decreasing the side effects.

Adult↗
PubMed1981

[Damage factors in tobacco and tobacco smoke].

In the last 30 years the production and consumption of cigarettes are increasing permanently. Till now more than 2200 noxious substances have been detected in the smoke of cigarettes. The origin and the synthesis of selected groups of these compounds and their distribution on main- and on sidestream smoke are described, furthermore the possibilities for estimation and control of nicotine abuse are reviewed. The incorporation of noxious substances of tobacco smoke result in a damage of clearance mechanisms of the lung and a change of loading by drugs and other metabolisable noxious substances, because the biotransformation processes are influenced by tobacco smoke. In this connection the importance of aryl-hydrocarbon-hydroxylase is discussed.

Aryl Hydrocarbon Hydroxylases↗