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J M Rodríguez-Sasiain

Publications and source records attributed to J M Rodríguez-Sasiain.

7 recordsLinked to original sources
PubMed1998

[Adverse drug reaction surveillance in pediatric and adult patients in an emergency room].

BACKGROUND: Adverse drug reactions (ADR) in the pediatric emergency room of a tertiary care hospital in Spain are described and compared with the adult ward. METHODS: Identification of cases was carried out through review of admission diagnoses and selection of those included in a previous list of diagnoses considered as possible ADR, that were thereafter verified. RESULTS: During 25 months, in 47.107 pediatric consultations were detected 451 cases as suspicious of ADR (0.96%). The ADR was moderate in 29 and serious in 1, being hospitalized 4. In adults, there were 68,431 consultations, and 704 cases detected (1.03%); moderate 218, serious 34 and mortal 1, being hospitalized 101. The most common reactions were dermatological (43.9% in children, 19.5% in adults) and of digestive nature (28.5 and 36.6%, respectively). The drugs most frequently involved in children were antimicrobials (49.5%), drugs used in respiratory illnesses (19.9%), non-steroid anti-inflammatory drugs (NSAID) (10.4%) and vaccines (9.2%); only two recently marketed products were involved. In adults, drugs involved were NSAID (28.2%), cardiovascular drugs (15.9%), antimicrobials (14.5%) and drugs active in digestive system (11.1%). There were 10 cases of hypoglycemia in diabetic adults, probably by interaction of hypoglycemic agents with angiotensin-converting enzyme inhibitors, and 7 cases of gastrointestinal hemorrhage associated with ketorolac, that generated an alert; 12 recently marketed products were involved. CONCLUSIONS: Intensive monitoring in emergency ward measures ADR problem, estimates underreporting, but it has a moderate value to generate alert or to survey new products.

Adolescent↗
PubMed1994

Decrease in penbutolol protein binding as a consequence of treatment with some alkylating agents.

The effect of in vitro treatment of serum with the alkylating agents carmustine (BCNU) and mechlorethamine on the protein binding of penbutolol, a basic agent mainly bound to alpha 1-acid glycoprotein (AAG), was investigated. The free fraction of penbutolol increased significantly (P < 0.001) after the treatment of serum with BCNU (5.27+ +/- 0.47%) and with mechlorethamine (5.23% +/- 0.17%), being 1.98% +/- 0.18% in serum not treated with BCNU or mechlorethamine. In addition, after incubation with BCNU (2 h), the free fraction of penbutolol continued increasing (10.96% +/- 0.70% vs 5.27% +/- 0.47% at time 0; P < 0.001), whereas it remained unchanged after incubation with mechlorethamine. Moreover, dialysis against saline for 24 h did not restore the free fraction of penbutolol, which increased after treatment with carmustine (9.05% +/- 1.24% vs. 11.04% +/- 1.55%, nondialyzed). We concluded that the treatment of cancer patients with alkylating agents could alter the serum proteins and modify their binding capacity, and this should be taken into account in the simultaneous treatment of these patients with other basic drugs like penbutolol, e.g., methadone.

Adult↗
PubMed1994

The extent of sodium and water administration associated with i.v. drug infusions in a surgical unit.

OBJECTIVE: To quantify sodium and water administered to surgical patients but not actually prescribed by the physician. METHODS: Computerized medication records of 1208 surgical patients who were operated on in 1992 were analysed retrospectively. Only prescriptions for intravenous (i.v.) drugs and fluids were selected. RESULTS: Thirteen of 143 i.v. drugs made up 68.3% of prescriptions for i.v. drugs. Patients received a median of three i.v. drugs daily. Patients were on i.v. therapy for a mean of 4.6 +/- 6.0 days (range 1-140, median 3 days). On 24% of patient-days, patients received more than 100 mEq of sodium which was not consciously prescribed, and on 20.4% of patient-days they had an extra daily intake of 750 ml of water or more. One fourth of the total sodium and more than 15% of fluid administered to patients was in the form of NaCl 0.9%, used as a vehicle for i.v. drugs. CONCLUSIONS: There is a considerable amount of sodium and water administered to patients without a specific prescription. The promotion of knowledge about the correct administration of i.v. drugs is an important task for the clinical pharmacist. If this is achieved, it will allow for an optimal administration of drugs as well as the prevention of possible side effects from an intended sodium and water administration.

Body Fluids↗
PubMed1993

Netilmicin kinetics in urology.

Plasma kinetics of netilmicin, an aminoglycoside antibiotic was studied in 62 patients undergoing urologic surgery. Despite the use of a standard 100 mg-dose, no toxic levels were achieved except in one patient. A poor correlation was found between netilmicin plasma elimination constant and creatinine clearance (r = 0.34, p = NS). We can conclude that the prediction of netilmicin plasma concentrations is not possible using only demographic patient's data. The monitoring of netilmicin levels should be performed in long-term treatments but not in 4-dose regimes such as in urologic prophylaxis.

Adult↗
PubMed1992

The influence of renal failure on the kinetics of intravenous midazolam: an "in vitro" and "in vivo" study.

The effect of renal failure upon the "in vitro" binding of midazolam, a new water-soluble short-acting benzodiazepine, has been studied in man. An increase of its free fraction (ranging from 2.52 to 5.17%) in serum from uremic patients was observed. A similar situation was originated in rabbits by administering uranyl nitrate (2 mg/Kg i.v.) and posterior hypnosis with midazolam. Uremic rabbits showed a marked increase in the free concentration of midazolam in serum (ranging from 8.9 to 13.7 micrograms/ml) and in midazolam brain levels (156.2 micrograms/g in cortex vs 84.5 micrograms/g in control animals). A positive correlation between brain and serum free concentration of midazolam was also observed. It is concluded that in renal patients more unbound drug is available to produce central nervous system effects, and a decrease in intravenous dose of midazolam could be recommended in this clinical situation.

Adolescent↗
PubMedDate not supplied

Differential effect of cancer on the serum protein binding to mianserin and imipramine.

Protein binding of mianserin and imipramine in vitro was determined in sera from 10 patients with cancer and from 28 drug-free normal subjects. alpha 1-acid glycoprotein (AAG) concentrations ranged from 0.91 +/- 0.04 g/l in control subjects to 2.17 +/- 0.18 g/l in cancer patients. Albumin concentrations ranged from 55.80 +/- 1.68 g/l in control subjects to 39.71 +/- 4.40 g/l, respectively. Serum samples containing concentrations of 100 ng/ml for mianserin and 500 ng/ml for imipramine were ultrafiltered and the free concentration were measured with scintillation spectrophotometer. The mean free percentage of mianserin was significantly less in patients with cancer (8.70 +/- 0.29% in patients vs 14.30 +/- 0.50% in control subjects P < 0.001). A multiple regression analysis revealed a significant contribution of plasma AAG (r2 = 0.56, P < 0.01), but not of albumin to the overall variability in mianserin binding. No correlation was observed between protein binding of imipramine and AAG concentrations in serum of cancer patients. No significant changes were observed for protein binding of imipramine in cancer patients as compared with control subjects. Our results suggest that for antidepressant (AD) drugs, of which the binding depends on AAG, variability in protein binding could be expected in cancer patients. Thus, in cancer therapy, changes in analgesic doses could be necessary with this kind of antidepressant drug.

Adolescent↗