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Biomedical subjects

J Kopferschmitt

Publications and source records attributed to J Kopferschmitt.

At least 37 records · Page 2Linked to original sources
PubMed1983

Acute voluntary intoxication by ricin.

1 A 21-year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse. 2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions. 3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed.

Adult↗
PubMed1983

[Pulmonary edema caused by heroin. Hemodynamic study of 2 cases].

The authors report two cases of heroin induced pulmonary edema. In both cases the severity of respiratory failure, attested by a deep hypoxemia (paO2 28 and 32 mmHg) and a metabolic and respiratory acidosis (pH 7.07 and 7.14) imposed an artificial ventilation with positive end expiratory pressure (PEEP). Hemodynamic study revealed a noncardiogenic edema. In both cases, a cardiac insufficiency was also present : in the first case it's etiology remained unclear, in the second it was a complication of hyperkalemia.

Acidosis↗
PubMed1983

[Acute poisoning by inhalation of metallic vapors].

Seven cases of acute intoxications by inhalation of metallic vapors are reported. The metals involved were zinc in three cases, tin in one case and mercury in three cases. The severity of the respiratory symptoms was dependent from the inhalated metal. The inhalation of zinc or tin vapors produced an acute limited pneumonitis. A lesional pulmonary oedema and acute interstitial fibrosis with lethal outcome was observed in two cases of intoxication by mercury vapors. The treatment by dimercaptopropanol used in mercury intoxications, increased urinary mercury excretion, but did not improve the pulmonary symptoms.

Adult↗
PubMed1982

[Pharmacokinetics of intramuscular mezlocillin in patients with normal and impaired renal function (author's transl)].

Pharmacokinetic values of mezlocillin were determined after a single intramuscular injection of 1 g to 10 subject with normal renal function, 10 patients with stable renal insufficiency and 5 patients with chronic renal failure under long-term haemodialysis. The values obtained in normal subjects were : biological half-life Tb 1/2 0.9 hour; elimination constant Ke 0.790 (h-1); total clearance Ct 449 ml/min/1.73 m2; renal clearance Cr 263 ml/min/1.73 m2. Twelve hours after the injection 72.2 % of the dose administered were recovered in the urine. Theoretical values after repeated injection were calculated from the values obtained in subjects with normal renal function. The loading doses providing steady state serum concentrations were determined for various dosage intervals (2, 3, 4, 6 and 8 hours). In patients with renal insufficiency or treated with haemodialysis, serum levels decreased more slowly. The theoretical Tb 1/2 for zero creatinine clearance was 4.7 hours. Sixty-two percent of the amount of mezlocillin present in the central compartment at the onset of haemodialysis were removed after a 6-hour dialysis session. In all 25 subjects investigated, a significant correlation was found between Ke and Ccr (Ke = 0.1973 + 0.0046 Ccr). This correlation was used to calculate the loading and maintenance doses (and sometimes also the intervals between injections) adjusted to renal function values. Dosage guidelines in relation to the renal function were established from these data.

Humans↗
PubMed1982

[Comparative biliary excretion of mezlocillin and 12 other beta-lactam antibiotics (author's transl)].

The biliary excretion of mezlocillin was studied on an experimental in vitro model (perfused rabbit liver) and by various methods in man. After addition of 10 mg mezlocillin to blood perfusing isolated rabbit lever preparations (n = 5) during 3 hours, a mean biliary peak of 758 +/- 129 micrograms/ml was recorded between 30 and 60 minutes. The 0-3 h cumulative biliary excretion was 20.3 % of the dose administered. Following a 30 min intravenous infusion of 5 g mezlocillin to 5 healthy subjects, the mean maximal antibiotic activity in the duodenal aspiration fluid was 626.0 +/- 115.0 microgram/ml during the first hour. In 10 cholecystectomized patients with T-tube drainage who received 1 g mezlocillin intramuscularly, a mean biliary peak of 296 +/- 58 micrograms/ml was recorded. The 0-12 h cumulative biliary excretion of the antibiotic was 2.6 % of the dose injected. After intravenous infusion of 5 g mezlocillin, the corresponding values were 505 +/- 118 micrograms/ml and 1.3 % respectively. One hour after rapid intravenous injection of 2 g mezlocillin, the antibiotic activities in samples of serum, common bile duct bile and gallbladder bile collected during cholecystectomy were 28.9 +/- 5.3, 895 +/- 196.1 and 402 +/- 133.2 micrograms/ml respectively. These results were compared with those obtained in similar conditions with 12 other beta-lactam antibiotics.

Animals↗
PubMed1982

[Acute nadoxolol poisoning. A multicentric study of 35 cases].

Between 1976 and 1980, 35 cases of nadoxolol poisoning were collected from french antipoison centers. Acute intoxication was voluntary (50%) or accidental (50%). The ingested dose ranged between 0,25 and 22,5 g. Clinical symptoms appeared three hours after ingestion and consisted of cardio-vascular disorders which were present in 10 patients: bradycardia (7 cases), cardiogenic shock (6 cases), intraventricular block (5 cases), increase of P.R. interval (4 cases) and Q.T. interval (3 cases). The toxic dose in otherwise healthy adults was 5 g. The treatment consisted of gastric lavage and correction of cardiovascular disorders with sodium lactate (4 cases) or dopamine (1 case). All the patients recovered.

Acute Disease↗
PubMed1981

[Experimental and clinical study of the biliary elimination of mezlocillin (author's transl)].

The biliary elimination of mezlocillin was studied in 5 perfused rabbit liver preparations. After adding 10 mg of mezlocillin to the perfusion medium, the biliary peak averaged 758 +/- 129 microgram/ml and total mezlocillin recovery within 3hr amounted to 20.3% of the administered dose. In 5 healthy subjects, the mean levels in the duodenal fluid collected during the 4 hrs following an infusion of 5 g of mezlocillin ranged from 440 to 637 microgram/ml. In cholecystectomized patients provided with a T-tube drainage, the maximal concentration after the same dosage (n = 10) was 505 +/- 158 microgram/ml and cumulative biliary excretion of mezlocillin over a 12 hr period corresponded to 1.3% of the administered dose. Under the same conditions, after intra-muscular injection of 1 g of mezlocillin to 10 subjects, the biliary peak averaged 292 +/- 58 microgram/ml and the total biliary recovery 2.6% of the administered dose. In 10 patients undergoing biliary tract surgery, the levels determined 1 hr after IV injection of 2 g of mezlocillin reached 896 +/- 196 microgram/ml and 402 +/- 133 microgram/ml in the main duct and in the gallbladder bile, respectively. These results were compared with the values obtained under identical conditions with 12 other beta-lactam antibiotics.

Animals↗
PubMed1980

Biliary elimination of mezlocillin: an experimental and clinical study.

The biliary elimination of mezlocillin, a new semisynthetic penicillin of the acyl-ureido-penicillin group, was investigated in vitro in rabbit liver preparations and in vivo in humans. Experimentally, mezlocillin recovery in the bile during perfusion of isolted rabbit liver (3 h; n = 5) averaged 20.3% of the administrered dose (10 mg). The mean peak concentration in the bile (758 +/- 129.3 micrograms/ml) was reached between 0.5 and 1 h. Biliary clearance was 169 ml/h. In healthy subjects (n = 5), the concentrations of antibiotic measured in the duodenal fluid during a period of 4 h after intravenous administration of 5 g of mezlocillin ranged between 440 and 637 micrograms/ml. In 10 cholecystectomized patients provided with a T-tube, intramuscular injection of 1 g of mezlocillin resulted in a biliary peak concentration of 295.7 +/- 58.1 micrograms/ml. Mean total amount of antibiotic eliminated in the bile over 12 h corresponded to 2.6% of the administered dose. Assays performed during surgery after intravenous administration of 2 g of mezlocillin (n = 10) showed antibiotic activity of 895 +/- 196 micrograms/ml in the common duct bile and 402 +/- 133 micrograms/ml in the gallbladder bile. These data were compared with the values determined for 11 other beta-lactamines studied under identical conditions.

Animals↗
PubMed1979

Cefamandole pharmacokinetics and dosage adjustments in relation to renal function.

The pharmacokinetic characteristics of cefamandole were determined after intravenous administration of a 1-Gm dose to 10 subjects with normal renal function, 10 patients with stabilized renal failure, and five chronic nephritic patients included in a intermittent hemodialysis program. In normal subjects, biological half-life (t1/2) averaged 0.94 hour, the overall elimination rate constant (Ke) was 0.7378 (hr-1), total clearance (Ct) was 223 ml/min/1.73 m2, renal clearance (Cr) was 164 ml/min/1.73 m2, and urine recovery of cefamandole over the 6 hours following a dose amounted to 74 per cent of the administered dose. In patients with stabilized renal failure and in patients on hemodialysis, biological half-life was markedly increased, with a theoretical value of 10.4 hours in case of a creatinine clearance of zero. The amount of antibiotic extracted over a 6-hour dialysis period accounted for 29 per cent of the cefamandole present in the vascular compartment at the beginning of the dialysis procedure. A significant correlation was established between the values of Ke and creatinine clearances, Ccr: Ke = 0.0289 + 0.0063Ccr (r = 0.937). This relationship was used to calculate the loading dose (LD), maintenance doses (D), and dosage intervals (tau) with regard to renal function. From these data recommendations regarding the adjustment of cefamandole dosage to the renal status can be made.

Cefamandole↗
PubMedDate not supplied

Clinical features and management of poisoning due to antimalarial drugs.

The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self-correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Antimalarials↗
PubMedDate not supplied

Toxicokinetics of lithium intoxication treated by hemodialysis.

A 66-year old female on long-term lithium therapy, developed neurologic toxicity with coma and convulsions. The treatment consisted artificial ventilation, fluid and electrolyte infusions and a six hour hemodialysis (HD) on days 2, 3 and 4. The convulsions disappeared on day 4; the patient regained consciousness on day l2 and recovered with slight sequelae. Toxicokinetic studies were conducted for a period of 12 days. The lithium (Li) serum concentration fell from 4.4 mmol/l on admission to 2.16 before HD and 0.35 after three HD. Li serum half life was 54 hours before HD, 25 hours during the three days on which HD was carried out and 106 hours thereafter. The Li cerebrospinal fluid/Li serum ratio ranged between 0.4 and 0.6 and was not influenced by HD. Mean renal clearance was 10.6 ml per min. During hemodialysis, Li serum half life decreased to 3.5 - 4.9 hours and clearance was 108 ml/min. A total amount of l28.6 mmol lithium was excreted; 84.3 mmol by HD and 44.3 mmol in urine. Patient's clinical course and electroencephalographic signs were correlated with the calculated cellular pool of Li but not with Li serum concentrations. This study confirms the effectiveness of HD to decrease the cellular pool of lithium. However, rather than considering only the absolute Li serum concentration, the presence of a rebound peak after HD may be viewed as indication for further hemodialysis.

Aged↗
PubMedDate not supplied

[Toxicity of calcium inhibitors].

Calcium antagonists decrease the intracellular concentration of calcium ions. They act essentially on the smooth vascular muscle, on the cardiac muscle and on the automatic and conducting cells in the heart. At toxic doses these effects induce hypotension, shock and disturbances of sinusal automatism and atrio-ventricular conduction. The toxicity of the different calcium antagonists varies according to their tissue specificity. The treatment of overdose includes gastric lavage, oral activated charcoal, cardiorespiratory support, especially alphamimetic vasopressors for shock or hypotension, adrenaline or cardiac pacing for atrio-ventricular block.

Animals↗