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Biomedical subjects

J A Gamble

Publications and source records attributed to J A Gamble.

12 recordsLinked to original sources
PubMed1992

Thoracic epidural infusion for postoperative pain relief following abdominal aortic surgery: bupivacaine, fentanyl or a mixture of both?

Thirty patients who had undergone elective abdominal aortic surgery were studied in a prospective, randomised double-blind comparison of thoracic epidural 0.2% bupivacaine alone, thoracic epidural fentanyl alone and thoracic epidural 0.2% bupivacaine combined with fentanyl. Pain relief, pulmonary function, cardiovascular stability and side effects were assessed. Pain relief was excellent in the combined bupivacaine-fentanyl series, being significantly better than the other groups (p less than 0.05) during the entire study period and was not accompanied by hypotension. Forced expiratory parameters were reduced in all groups throughout the study to 50-60% of the pre-operative values, but there were no significant differences between groups. The incidence of side effects attributable to either epidural bupivacaine or fentanyl was low. This study supports the increasing use of epidural infusion analgesia for postoperative pain management after abdominal surgery.

Adult↗
PubMed1977

A study of plasma diazepam levels in mother and infant.

A 10 mg dose of diazepam was given intravenously to mothers at 15 to 205 minutes before delivery, and plasma diazepam concentrations were measured by gas-liquid chromatography in mothers and infants at delivery and again 24 hours later. The plasma levels in the infants were always significantly higher than in the mothers but there was no evidence to suggest that the newborn were unable to metabolize the drug. All infants had a good Apgar score at birth.

Adult↗
PubMed1976

Plasma diazepam concentrations following prolonged administration.

Plasma diazepam and N-desmethyl diazepam concentrations were measured in patients receiving diazepam 5 mg or 10 mg i.v. at 4-h intervals for periods of 6-22 days. At both doses there was an accumulation of both diazepam and its metabolite, the latter reaching concentrations of up to two to three times that of the parent drug. Plasma diazepam concentrations reached a plateau after 8 days while the concentration of N-desmethyl metabolite continued to increase throughtout the period of drug administration. On discontinuation of diazepam therapy both diazepam and N-desmethyl diazepam concentrations decreased slowly, the former with a half-life of 2-4 days and the latter with a half-life of 4-8 days.

Adult↗
PubMed1976

The influence of three antacids on the absorption and clinical action of oral diazepam.

Diazepam 10 mg given orally alone or with one of the three antacids (aluminium hydroxide 40 ml, magnesium trislicate 30 ml, sodium cirate 30 ml) was given in a single dose at random to 200 women undergoing minor gynaecological procedures. The concomitant use of aluminium hydroxide or sodium citrate hastened the onset of the soporific effect of diazepam marginally, while magnesium trisilicate tended to delay it. The estimation of plasma diazepam concentrations over 90 min in a similar series of 67 patients showed that the absorption of diazepam was increased significantly by the use of aluminium hydroxide, but there were no striking differences in the four groups. The clinical implications of these findings are discussed.

Administration, Oral↗
PubMed1976

Some pharmacological factors influencing the absorption of diazepam following oral administration.

Plasma diazepam concentrations were measured by gas-liquid chromatography in samples of blood from adult female patients follwing diazepam 10 mg orally, alone or in combination with metoclopramide, morphine, pethidine or atropine. Patients receiving metoclopramide had higher plasma diazepam concentrations than those in the control group, while the addition of morphine, pethidine or atropine resulted in lower plasma diazepam concentrations throughout the 90-min period of the study. In the control goup peak plasma concentrations were reached by 60 min. The addition of metoclopramide increased the rate of diazepam absorption and peak concentrations were reached by 30 min, while morphine, pethidine and atropine reduced the rate of absorption with no apparent peak being reached by 90 min.

Administration, Oral↗
PubMed1975

The influence of the route of administration on the clinical action of diazepam.

The relative efficacy of diazepam 10 mg as a premedicant was assessed following its oral and intramuscular administration, using a "double-blind, double-dummy" technique, as well as its effect when given by both routes. Drugs were given to a standard patient population who were undergoing the same type of operation and receiving a standard anaesthetic. The most rapid onset of soporific action occurred when diazepam was given by mouth and this produced the best effect throughout the period of the study although its efficacy began to pass off after 60 minutes. It was superior in effect to the same dose injected into the thigh. The combined effect of oral and intramuscular diazepam was not notably greater than tht of the single oral dose. The injection of diazepam was followed by an unacceptably high incidence of pain, particularly when this was given into the thigh. There were no significant differences in either the course of anaesthesia or the incidence of post-operative nausea and vomiting. When the undesired effects are taken into consideration, the oral administration of diazepam should be the route of choice.

Administration, Oral↗
PubMed1975

Plasma diazepam levels after single dose oral and intramuscular administration.

Plasma diazepam levels were estimated by gas-liquid chromatography following a single 10 mg dose administered to a health adult female population by the oral and intramuscular routes. The highest levels were achieved following oral administration, reaching a peak at 60 minutes, although injection into the thigh resulted in a more rapid rise initially. Injection into this site produced higher levels than when the buttock was used. Injection by nurses into the latter site produced particularly low plasma levels over the 90-minute period of study. The plasma levels found at 90 minutes following the oral and thigh routes were found to be closely correlated with the weight of the patient.

Administration, Oral↗