Synthesis and antihypertensive activity of substituted (2,6-dichlorobenzylideneamino) guanidines and some hydrazone derivatives of C-cyanoformamidrazone.
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Biomedical subjects
Publications and source records attributed to H Selander.
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Oral doses of 1 to 100 mg amiflamine, a new reversible monoamine oxidase type A-selective inhibitor, were given for the first time in humans to six healthy men. No apparent pharmacologic effects were recorded until the 80 mg dose. After 100 mg, one subject developed symptoms indicative of an overdose. Amiflamine is extensively metabolized by two consecutive N-demethylations. The biotransformation patterns in plasma and urine were found to correlate with the debrisoquin metabolic ratio.
During two baseline challenge tests, oral tyramine (50 to 400 mg) was given to 12 healthy men to find each individual's cardiovascular pressor response. All 12 subjects "tolerated" 200 mg oral tyramine, but three of the 12 developed an increment in systolic blood pressure greater than 30 mm Hg when given a dose of 400 mg. Thereafter, amiflamine, 5 mg bid (n = 8), or placebo, 1 capsule twice a day (n = 4), were given in a double-blind fashion for 7 days, and oral tyramine challenge tests (12.5 to 400 mg) were given on days 5 to 7. During dosing with amiflamine or placebo, no subject tolerated 400 mg oral tyramine and no difference between the two regimens was found with regard to tyramine response. Plasma concentrations of amiflamine and two of its metabolites were measured on days 4 to 7. Steady-state concentrations were reached within 4 to 5 days. Plasma concentrations of tyramine after 400 mg tyramine showed a positive correlation with the increase in systolic blood pressure (P less than 0.001).
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The computerized anaesthetic record-keeping system at the Karolinska hospital at present (1980) contains anaesthetic records from approximately 200,000 cases. In order to evaluate the importance of circulatory disturbances during routine anaesthetic work, all records from 1967-1977 were searched for notes concerning complications. 5,996 anaesthetics were thus retrieved, having a total of 7,296 complications. This corresponds to an overall frequency of slightly more than 4 p. cent. Circulatory disturbances amounted to approximately 10 p. cent of all complications. Arrhythmias were common. Serious troubles i. e. circulatory arrests were very rare and these cases were studied individually. Differences in the frequency of complications as correlated to the preanaesthetic status of the patient including the risk group and diagnosis could be demonstrated. It is concluded that circulatory complications during anaesthesia exhibit patterns that can be analyzed from data collected during routine anaesthetic work provided a computerized anaesthetic record-keeping system is used.
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