Angiotensin-converting enzyme inhibitors and cough.
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Biomedical subjects
Publications and source records attributed to J L Straughan.
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Buspirone (Buspar; Bristol) marks a departure from established concepts of anxiolysis. Differing substantially both in its mode of action and in the clinical expression of its action from agents such as barbiturates and benzodiazepines, it would seem to operate chiefly via the 5-HT1A subtype of serotonin receptor. Such receptor selectivity is likely to be responsible for the novel action of this anxiolytic in that sedation and psychomotor and cognitive dysfunction are minimal, and because dependence is unlikely. The slower onset of full therapeutic benefit further delineates the differences between buspirone and other anxiolytics. However, it is apparent that the benzodiazepines will not readily be displaced from all of their varied applications by buspirone. This review examines buspirone and provides some guidelines for its use.
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While no major differences with regard to psychopharmacological actions are to be found among the benzodiazepines, certain pharmacokinetic differences are known. These differences allow the benzodiazepines to be classified as cumulative or non-cumulative; the differences between these two groups are further dissected and evaluated, in an attempt to rationalize therapy with these agents.
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Chlordiazepoxide and its 4 major metabolites were assayed after separation by thin-layer chromatography following extraction from biological fluids. The compounds become intensely fluorescent in the presence of red, fuming nitric acid. The resulting compounds are quantitated with a spectrodensitometer with a fluorescent attachment. The sensitivity varies between 0.05 and 0.1 microgram. The coefficient of variation is 1.4% for assays in urine and 6.4% in serum.
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The erythromycins are broadly reviewed from a clinical viewpoint. The antimicrobial spectrum, clinical indications, pharmacokinetics and toxicity are dealt with. The usefulness of erythromycin for respiratory tract infections is stressed. New evidence to support bactericidal activity of this antibiotic is noted. There seems little reason to use the potentially hepatotoxic estolate form of erythromycin. The safety of the other forms of this antibiotic available in this country is emphasized.
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The design, surgical insertion and results of a plastic draining implant for severe glaucoma are reported. The need for pharmacological control of bleb inflammation is stressed and the favourable long-term outlook for patients with such implants is discussed.
The methods used to identify and evaluate anti-inflammatory agents, and the effects of a triple drug regimen, consisting of oral prednisone and flufenamic acid and topical l-adrenaline in controlling bleb inflammation and fibrosis around drainage implants in patients with terminal glaucoma are described. The benefits of anti-inflammatory agents in other surgical glaucoma procedures are suggested.
Endogenous uveitis is an important cause of blindness in young adults. The need for a comprehensive search for an aetiological 'antigen' is stressed. A source of adjuvant, disturbance in host immunology and any associated syndromes are also sought. Treatment then involves elimination of 'antigen', suppression of host hypersensitivity and the enhanced vascular permeability, and improvement of host resistance. The value of antihistamine and antiserotonin drugs in successful treatment is emphasised.
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