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Biomedical subjects

H Pettit

Publications and source records attributed to H Pettit.

6 recordsLinked to original sources
PubMed2000

Opioid and benzodiazepine withdrawal syndrome in adult burn patients.

The prolonged use of continuous intravenous sedation [benzodiazepines (BZDs)] and pain medication [opioids (OPs)] is now common in intensive care units. Few studies have evaluated the characteristics that may lead to an acute withdrawal syndrome when these long-term medications are withdrawn. Those studies that have made recommendations for weaning rates to prevent withdrawal have given these recommendations with minimal data to support their recommendations. The purpose of this study was to retrospectively review the records of adult burn patients for the presence of acute BZD or OP withdrawal syndrome and to characterize whether patterns of BZD or OP administration or weaning rates contribute to the development of acute withdrawal syndrome. We found no relation of acute withdrawal syndrome to peak dose, total dose, or duration of dose of BZD/OP before the terminal withdrawal phase. There was a significant relationship between the rate of BZD/OP weaning in the terminal drug withdrawal phase and the percentage of days that patients experienced withdrawal symptoms (P < 0.005). Those patients who underwent a prolonged terminal weaning from these medications experienced fewer symptoms. The optimal rate of weaning that would allow decreased ventilator and intensive care unit length of stay without development of acute withdrawal symptoms is yet to be determined.

Adult↗
PubMed1996

Mixed-effect modeling for detection and evaluation of drug interactions: digoxin-quinidine and digoxin-verapamil combinations.

Mixed-effect modeling has been suggested as a possible tool to detect and describe drug interactions in patient populations receiving drug combinations for the treatment of disease states. The mixed-effect modeling program, NONMEM, was used to measure the effects of the well-known digoxin-quinidine and digoxin-verapamil drug interactions in 294 patients receiving oral digoxin as hospital inpatients. Fourteen percent of the population took either quinidine or verapamil concurrently with digoxin (mean quinidine dose = 857 +/- 397 mg/day, verapamil = 261 +/- 110 mg/day). Two regression models for digoxin oral clearance were used. Model 1 used the knowledge that digoxin is eliminated by both renal and nonrenal routes (TVCL = ClNR+m.CrCl, where TVCL is the population digoxin oral clearance, ClNR is the nonrenal clearance, and m is the slope of the line that relates creatinine clearance (CrCl) to digoxin clearance); model 2 used a more conventional regression approach with a simple series of multipliers. For both models, quinidine administration decreased population digoxin oral clearance by approximately 45% and verapamil therapy decreased population digoxin oral clearance by approximately 30%. These values are similar to those found by traditional drug interaction studies conducted in small patient or normal subject populations. Mixed-effect modeling can detect clinically relevant drug interactions and produce information similar to that found in traditional pharmacokinetic crossover study designs.

Adult↗
PubMed1986

Repeated pemoline produces self-injurious behavior in adult and weanling rats.

Self-injurious behavior (SIB) is a serious problem among the mentally handicapped and is often accompanied by other repetitive or stereotyped behaviors. Acute administration of high doses of amphetamine or pemoline to rats produces transient SIB which is accompanied by severe deterioration of the behavioral repertoire. Repeated subcutaneous (SC) administration of pemoline to rats produces a high incidence of SIB without the dramatic behavioral changes produced by high doses of oral pemoline. Repeated pemoline increased locomotions and rears and produced intermittent stereotyped sniffing and licking/biting. However, the animals were still able to eat, drink, sleep and groom. Hotplate tests provided no evidence for analgesia. Because SIB is often associated with human developmental disorders, the effects of repeated SC administration of pemoline to weanling rats was also investigated. SC injections every 12 hours produced a high rate of SIB in weanling rats.

Animals↗