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Biomedical subjects

J Felice-Johnson

Publications and source records attributed to J Felice-Johnson.

3 recordsLinked to original sources

Effect of erythromycin stearate on serum theophylline concentration in patients with chronic obstructive lung disease.

The effect of erythromycin stearate (ES) on serum theophylline concentration (STC) was studied in 15 male adult subjects taking maintenance oral theophylline for clinically stable chronic obstructive lung disease. Steady-state trough STCs were measured before and after two- and seven-day courses of ES, 500 mg every six hours. For the group as a whole, there was no significant increase in trough STC after either course of ES therapy, but five of 15 subjects exhibited increases in trough STC ranging from 4 to 8 micrograms/ml (mean increase of 5.4 micrograms/ml) within 48 to 96 hours of beginning ES therapy. Clinical theophylline toxicity developed in one of these subjects. Based on this study and others in the literature, erythromycin preparations may induce a clinically significant and potentially toxic increase in STC in a variable proportion of patients taking maintenance theophylline therapy.

Administration, Oral↗

Malignant hyperthermia: current perspectives.

The incidence, etiology, clinical manifestations, and management of malignant hyperthermia (MH) are reviewed. The syndrome of MH is recognized as one of the causes of anesthesia-related deaths. It is considered pharmacogenetic because both an abnormal gene and precipitating environmental factors are necessary to produce an acute reaction. Metabolic defects, involving a derangement of calcium dynamics, appear to be the common characteristic of susceptible individuals. Calcium release and uptake from the sarcoplasmic reticulum is altered when an individual with MH is exposed to certain anesthetic agents or triggering physical and emotional stresses. Muscle rigidity, tachycardia, tachypnea, and high fever can lead to other complications and death. Management of an acute reaction of MH includes cooling methods to lower body temperature, hyperventilation, sodium bicarbonate control of acidosis, maintenance of fluid and electrolyte balance, and the administration of dantrolene sodium. A thorough family history, baseline CPKs, caffeine-halothane contracture tests, and ultramicroscopic examination of muscle biopsy specimens are recommended as screening techniques. The early administration of dantrolene sodium in acute reaction of MH has been shown to rapidly alleviate the symptoms and ensuing severe complications. Individuals with a strong family history of MH or previous episodes may be treated with oral dantrolene sodium before surgery to effectively prevent a crisis, and after surgery to prevent recurrence.

Creatine Kinase↗