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Biomedical subjects

J D Robinson

Publications and source records attributed to J D Robinson.

At least 127 records · Page 7Linked to original sources

Binding to the high-affinity substrate site of the (Na+ + K+)-dependent ATPase.

The (Na+ + K+)-dependent ATPase exhibits substrate sites with both high affinity (Km near 1 microM) and low affinity (Km near 0.1 mM) for ATP. To permit the study of nucleotide binding to the high-affinity substrate sites of a canine kidney enzyme preparation in the presence as well as absence of MgCl2, the nonhydrolyzable beta-gamma imido analog of ATP, AMP-PNP, was used in experiments performed at 0-4 degrees C by a centrifugation technique. By this method the KD for AMP-PNP was 4.2 microM in the absence of MgCl2. Adding 50 microM MgCl2, however, decreased the KD to 2.2 microM; by contrast, higher concentrations of MgCl2 increased the KD until, with 2 mM MgCl2, the KD was 6 microM. The half-maximal effect of MgCl2 on increasing the KD occurred at approximately 1 mM. This biphasic effect of MgCl2 is interpreted as Mg2+ in low concentrations favoring AMP-PNP binding through formation at the high-affinity substrate sites of a ternary enzyme-AMP-PNP-Mg complex; inhibition of nucleotide binding at higher MgCl2 concentrations would represent Mg2+ acting through the low-affinity substrate sites. NaCl in the absence of MgCl2 increased AMP-PNP binding, with a half-maximal effect near 0.3 mM; in the presence of MgCl2, however, NaCl increased the KD for AMP-PNP. KCl decreased AMP-PNP binding in the presence or absence of MgCl2, but the simultaneous presence of a molar excess of NaCl abolished (or masked) the effect of KCl. ADP and ATP acted as competitors to the binding of AMP-PNP, although a substrate for the K+-dependent phosphatase reaction also catalyzed by this enzyme, p-nitrophenyl phosphate, did not. This lack of competition is consistent with formulations in which the phosphatase reaction is catalyzed at the low-affinity substrate sites.

Adenosine Triphosphate↗

Evaluation of an educational program on compliance with medication regimens in pediatric patients with renal transplants.

An educational program was initiated in an attempt to improve compliance in taking medications among pediatric renal transplant patients. Compliance was assessed by pill counts and by knowledge about medications by interview and questionnaire before, during, and after a six-month study period. Forty-three percent of the population was initially found to be in some way noncompliant with medication regimens, and 19% remained so after extensive counseling and instruction. Factors associated with noncompliance were adolescence, female sex, and family instability. Compliance was associated with direct parental involvement and voluntary maintenance of medication calendars. Although knowledge about drugs significantly improved, there was no correlation with compliance; motivational factors appeared to be of greater importance.

Adolescent↗

Determining the "proper" gentamicin dosage in a hospital setting.

A method for determining a gentamicin dosage was applied to a patient in a community hospital setting. It was found that many factors, some beyond the practitioner's control, confused proper use of the drug. A case is used to illustrate the difficulties encountered in a community hospital setting when a seemingly straightforward protocol for gentamicin administration for therapy was initiated. The errors associated with each of five levels of personnel are illustrated which if summed could result in potentially serious consequences. In addition to reviewing the literature on gentamicin dosage schedules and making recommendations regarding future research in this area, specific guidelines are proposed for the use of gentamicin in clinical practice.

Aged↗

Blood levels of flupenthixol in patients with acute and chronic schizophrenia.

Plasma levels of flupenthixol were estimated by three methods in 30 patients with acute schizophrenia and 29 patients with chronic schizophrenia. These levels were related to clinical response, anterior pituitary hormone secretion, platelet monoamine oxidase activity, the effects of the concurrent administration of anticholinergic drugs, and body weight. No clearcut relationships between plasma flupenthixol levels and any of these variables were demonstrated. The practical clinical value of the estimation of plasma flupenthixol is limited at the present time.

Acute Disease↗

A radioimmunoassay for the determination of combined amitriptyline and nortriptyline concentrations in microliter samples of plasma.

A sensitive radioimmunoassay for amitriptyline and nortriptyline in blood has been developed. The antibodies used in the radioimmunoassay were raised in a sheep against a conjugate of nortriptyline and bovine serum albumin. Using tritiated amitriptyline as the label, the assay is capable of detecting concentrations as low as 2.0 ng/ml in a 50 microliter sample of plasma. Cross-reactivity studies have demonstrated the specificity of the radioimmunoassay for both amitriptyline and nortriptyline, and comparison with gas-liquid chromatography assay has indicated the applicability of the assay to a routine situation. The radioimmunoassay has been used to study the plasma drug levels after single oral administration of amitriptyline to four volunteers. A wide variation in maximum drug concentrations, ranging from 18 to 62 ng/ml, was seen, with the time taken to reach the maxima ranging between 1.5 and 3 hours. A second concentration peak was seen in three of the volunteers, at 4 to 5 hours after ingestion of the drug.

Amitriptyline↗

Measurement of plasma nortriptyline concentrations: radioimmunoassay and gas-chromatography compared.

We compared measurement of plasma nortriptyline by a recently developed radioimmunoassay technique with values obtained by traditional gas chromatography. The coefficient of correlation (r) was 0.98 for 84 samples from 21 controlled patients; for a separate series of 45 samples from 34 patients who were receiving in addition other medication, r was 0.96. Use of radioimmunoassay in the routine determination of plasma nortriptyline concentration is discussed.

Chromatography, Gas↗