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Biomedical subjects

J F Mitchell

Publications and source records attributed to J F Mitchell.

At least 37 records · Page 2Linked to original sources

Abciximab in primary coronary angioplasty for acute myocardial infarction improves short- and medium-term outcomes.

OBJECTIVES: The purpose of this study was to compare the outcome of primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (MI) when performed with or without the platelet glycoprotein IIb/IIIa antibody, abciximab. BACKGROUND: Abciximab improves the outcome of angioplasty but the effect of abciximab in primary angioplasty has not been investigated. METHODS: Data were collected from a computerized database. Follow-up was by telephone or review of outpatient or hospital readmission records. RESULTS: A total of 182 consecutive patients were included; 103 received abciximab and 79 did not. The procedural success rate was 95% in the two groups. At 30-day follow-up, the composite event rate of unstable angina, reinfarction, target vessel revascularization and death from all causes was 13.5% in the group of patients who did not receive abciximab, 4% (p < 0.05) in the abciximab group and 2.4% (p < 0.05) in the subgroup of patients (n = 87) who completed the 12-h abciximab infusion. At the end of follow-up (mean 7+/-4 months), the composite event rate was 32.4%, 17% (p < 0.05) and 13.1% (p < 0.01) in these three categories respectively. Abciximab bolus followed by a 12-h infusion was an independent predictor of event-free survival, in a Cox proportional hazards model (relative risk 0.49; 95% confidence interval 0.24 to 0.99; p < 0.05). CONCLUSIONS: Abciximab given at the time of primary angioplasty may improve the short- and medium-term outcome of patients with acute MI, especially when a 12-h infusion is completed.

Abciximab↗

Oral solid dosage forms that should not be crushed: 1994 revision.

This revision and update of an article published previously in Hospital Pharmacy (1992; 27:690-699) alerts healthcare practitioners about medications that should not be crushed. This list serves those who dispense and administer medications so that potential problems associated with disruption of special pharmaceutical formulations may be prevented. Products are identified that should not be crushed and for which a similar liquid form is available.

Administration, Oral↗

Pharmacy newsletters: time for a new approach.

P & T Committees are often responsible for preparing a drug information newsletter for the purposes of disseminating drug-related information to the rest of the medical staff. A large amount of time, effort, and expense is devoted to preparing a high-quality newsletter, but, unfortunately, data suggest that the correspondence is not often read by members of the medical staff. Therefore, the drug information newsletter needs to be examined and modified periodically to meet the needs of its readers. A mechanisms for providing drug information in a "pocket-guide" form that is easily kept for future and quick future reference was developed and is described.

Drug Information Services↗

The effect of depolarizing potassium concentrations on the efflux of GABA from rat dorsal medulla in vivo and from slices and synaptosomes.

The efflux of [3H]GABA from the dorsal surface of adult rat medulla overlying the dorsal column nuclei (DCN) was found not be influenced by increasing the concentration of potassium in the superfusing solution to 40 mequiv. Similarly, raised potassium was found not to influence the efflux from slices of the dorsal region of the caudal medulla containing the dorsal column nuclei. This lack of effect of raised potassium is not thought to be due to lack of GABAergic terminals in this region because there is good pharmacological evidence for their presence and bacause both electrical stimulation and 100 microM veratridine increased the efflux of [3H]GABA from such slices. Also, 40 mequiv potassium was found to increase the efflux of both endogenous and [3H]GABA from crude synaptosome preparations of this region without influencing the efflux of [14C]sucrose or [3H]leucine. This release of [3H]GABA was calcium-dependent, and was similar whether produced by 20, 40 of 60 mequiv potassium and occurred whether eos or AOAA was used to inhibit GABA metabolism. Release from synaptosomes could also be induced with 100 microM veratridine. Raised potassium was additionally found to prevent the increased efflux from slices produced by electrical stimulation and to increase the efflux from slices prepared from the brains of rats 14 days old. It is suggested that the astrocytic swelling produced by raised potassium concentration restricts the diffusion of GABA away from depolarized terminals.

Aminooxyacetic Acid↗

Successful oral anticoagulant therapy in a patient with short bowel syndrome.

The case of a 41-year-old male with a history of multiple emboli and short bowel syndrome who was successfully anticoagulated with sodium warfarin is described. The prothrombin times were stabilized in a therapeutic range with warfarin doses of 5.0 mg -7.5 mg daily. The pharmacokinetics of warfarin suggests that absorption is high in the proximal intestine. The successful use of sodium warfarin in the patient substantiates this finding and demonstrates that short bowel does not necessarily preclude the use of warfarin for anticoagulation. It is suggested that patients with short bowel syndrome may be successfully anticoagulated with oral products; however, careful monitoring of each patient's prothrombin time is necessary because of the variability and extent of bowel loss.

Adult↗