PubMed Health⌕ Search

Biomedical subjects

K Ghose

Publications and source records attributed to K Ghose.

At least 37 records · Page 2Linked to original sources
PubMed1985

Serum creatine kinase activity in the elderly following a stroke.

A serial measurement of serum creatine kinase (CK) activity and its isoenzymes were made in elderly patients following an acute stroke. Seven out of ten patients had elevated CK levels. The maximum concentration was observed between 12-24 h and the level returned to normal within 84 h after a stroke. They all had positive skeletal (MM) muscle isoenzyme, and in only one patient heart (MB) isoenzyme was detected. None of them had positive brain (BB) isoenzyme. Measurement of serum CK activity will possibly provide guidance in the management of patients having recently suffered a stroke.

Aged↗
PubMed1984

Mechanism of tyramine-induced migraine: similarity with dopamine and interactions with disulfiram and propranolol in migraine patients.

In a double-blind crossover study, 8 patients with classical migraine received disulfiram (400 mg/day) for 6 days, alternating with matched placebo tablets at 2 weekly intervals. Intravenous dopamine and tyramine pressor tests were performed on the 3rd and 6th days of each phase, respectively. 50-75% of patients experienced migraine attacks within 24 h of a test. There was no difference in the incidence of attacks between dopamine and tyramine injections. The number of migraine-free days was more during the placebo week than during disulfiram treatment (p less than 0.05). The post-tyramine migraine index correlated directly with the amount of tyramine administered during the dose-response test (r = 0.66), but no such relationship was found with dopamine. In a further study, post-tyramine migraine was observed in only 1 of 5 patients treated with propranolol (80 mg/day) for 4 weeks. Neither disulfiram nor propranolol influenced the tyramine pressor sensitivity. It is concluded that increased adrenergic activity is responsible for more frequent attacks during disulfiram medication. A similar mechanism probably is responsible for post-dopamine/tyramine migraine in susceptible subjects. It is unlikely that tyramine plays any specific role, except via its effect on the adrenergic system, in the pathogenesis of migraine attacks. However, the tyramine challenge test can be useful in the evaluation of a putative antimigranous activity of a new drug.

Adult↗
PubMed1984

Tyramine pressor test: implications and limitations.

Tyramine, an indirectly acting sympathomimetic amine, can be used as a pharmacological tool to assess the peripheral adrenergic activity and its interactions with drugs in man. Of the various techniques used, the tyramine pressor test appears to be the most reliable method. It is convenient to perform and carries no significant morbidity, provided the subjects are selected carefully and the investigation is closely monitored. Basically, the tyramine pressor test involves measurement of systolic blood pressure in response to bolus intravenous tyramine injections. Tyramine sensitivity, which is taken as an index of peripheral adrenergic function, is defined as the amount of tyramine required to increase the systolic blood pressure by 30 mm of Hg and is determined from the dose response curve. Drugs which influence the adrenergic system are likely to alter the tyramine sensitivity. It provides valuable guidance regarding drug interactions and is useful in the assessment of certain neuropsychiatric conditions. However, since tyramine does not cross the blood brain barrier, information regarding only the peripheral effect is obtained.

Adolescent↗
PubMed1983

Effect of dosage frequency of carbamazepine on drug serum levels in epileptic patients.

The effect of dosage frequency of carbamazepine (CBZ) (brand name Tegretol) on pseudo-steady state drug serum levels were studied in 14 male (16-18 years) epileptics. They had already been receiving CBZ (mean dose 13.7 mg/kg) for an average period of 2.3 years in combination with other antiepileptic drugs. During this investigation, total daily CBZ dose was kept unaltered, but they received medication in thrice, twice and once daily dosage regimes. Each treatment period lasted for 4 weeks. The profiles of 24 h serum drug levels as assessed at the end of each treatment period, were observed to be within the therapeutic range during these 3 regimes. However, as expected, there were higher fluctuations of serum CBZ concentrations during once daily medication than during divided dosage regimes. Other concomitant antiepileptic drugs were continued in 2-3 divided daily doses during these 3 treatment periods, and the serum drug levels were measured at 8 h prior to the morning dosing. The concentrations of other drugs remained unchanged apart from a slight decrease in the serum sodium valproate levels during once daily medication. No clinical or electroencephalographic adverse effects were observed and there was no significant change in the fit frequency. In view of this observation, CBZ (Tegretol tablet) is probably effective as a single daily dose, but further long-term controlled clinical trial is necessary.

Adolescent↗
PubMed1983

l-Tryptophan in hyperactive child syndrome associated with epilepsy: a controlled study.

The effect of l-tryptophan in childhood hyperkinesia was compared with placebo tablets in 11 epileptic boys, aged 7-14 years, in a residential school for epileptics. The mean age of epilepsy was 2.5 years, and the duration of hyperactivity varied between 1.3 and 5.5 years. They were receiving either carbamazepine or sodium valproate alone, or combinations of both drugs for epilepsy. The investigation was designed as a double-blind cross-over study in which the patients were selected randomly to receive either l-tryptophan (40 mg/kg body weight) or matched placebo tablets first. Each treatment phase lasted for 5 weeks and the alternative medication was given after a 3-week washout period. Concomitant antiepileptic drugs were kept unaltered and no other drug was prescribed during the study. The patients were assessed at the pre-entry period (basal) and at the end of each treatment phase by their teachers and child care staff. The rating scale used included Connor's teacher and parent rating scales, the Meanwood Park Hospital behaviour scale, and visual analogue scales. A record of the patients' seizure frequency was kept throughout the investigation. Plasma antiepileptic drug levels were monitored at the end of each phase and they were virtually identical during these two treatment periods. In the dosage used, l-tryptophan was tolerated well by these children, and seizure frequency, as a whole, remained unaltered. However, no significant beneficial effect on their behaviour was observed during 5 weeks of l-tryptophan therapy.

Adolescent↗
PubMed1983

Hypercupraemia induced by antiepileptic drugs.

Serum copper and zinc levels were measured in 84 treated male epileptics, aged between 6 and 18 years, by an atomic absorption spectroscopic method. These patients were selected randomly from a residential special school. Twenty drug-free healthy but educationally subnormal (ESN) male subjects of similar age group from the same school acted as controls. No abnormality in serum zinc level was observed. In nineteen (22.6%) epileptics, copper levels were above the upper level of normal range (20.5 mumol/l), whereas this was only marginally elevated (20.8 mumol/l) in one (5%) ESN subject. The mean copper level in all epileptics was higher than the controls (P less than 0.01), but there was no difference between the epileptics treated with sodium valproate alone and the ESN group. The patients who were receiving carbamazepine either as monotherapy or in combination with other drugs except phenytoin, had higher mean copper levels than the controls (P less than 0.01). A similar observation was made in relation with phenytoin polytherapy (but excluding carbamazepine). There also appeared to be an association between the high serum copper levels and diffuse/generalized electroencephalographic changes (P less than 0.001). Some antiepileptic drugs, particularly carbamazepine, can produce such electroencephalographic abnormalities. It is concluded that hypercupraemia observed in these treated epileptics were related to the induction of caeruloplasmin synthesis by phenytoin and carbamazepine.

Adolescent↗
PubMed1981

Once daily dosage versus divided daily doses of carbamazepine therapy in epileptic patients: a pilot study.

The effect of once daily dosage of carbamazepine on fit frequency, electroencephalogram (EEG), behaviour and 24-hour drug levels were compared with those following 2 to 3 divided daily doses treatment. The 14 male epileptics, aged 16 to 18 years, who were studied had already been receiving carbamazepine for an average period of 2.5 years in combination with other anti-epileptic drugs. In this investigation, these patients received their usual daily dose (mean dose 13.9 mg/dg) of carbamazepine in 3-time, twice and once daily regimens. Each treatment period lasted for 4 weeks. Plasma concentrations of carbamazepine and its epoxide metabolite remained within the therapeutic range during the three treatment periods, but the area under the curves were greater during once daily medication. There was also slight decrease in the plasma sodium valproate concentration during the once daily regimen, but the concentrations of other concomitant medication remained unchanged. No significant changes in fit frequency and behaviour were observed athe area under the curves were greater during once daily medication. There was also slight decrease in the plasma sodium valproate concentration during the once daily regimen, but the concentrations of other concomitant medication remained unchanged. No significant changes in fit frequency and behaviour were observed athe area under the curves were greater during once daily medication. There was also slight decrease in the plasma sodium valproate concentration during the once daily regimen, but the concentrations of other concomitant medication remained unchanged. No significant changes in fit frequency and behaviour were observed and none of these patients suffered from any side-effects or toxic effects during once daily medication. EEG revealed a slight increase in abnormality during twice daily medication, but no further deterioration was seen during one daily treatment. In view of this observation, carbamazepine is probably effective as a single daily dose, but further long-term controlled clinical trial in necessary.

Adolescent↗
PubMed1980

Decreased tyramine sensitivity after discontinuation of amitriptyline therapy. An index of pharmacodynamic half-life.

A combined pharmacodynamic and pharmacokinetic approach was made to study the pharmacodynamic half-life (Pd1/2) of amitriptyline (AT). Six depressed patients were treated with 150 mg of amitriptyline as a single oral dose at night for six or more weeks. Decreased tyramine sensitivity (DTS), an index of this drug's pharmacological activity, was determined serially at various intervals after the last dose. Plasma concentrations of AT and nortriptyline (NT) were also estimated at above intervals. It was possible to detect DTS for 228-300 h after the last oral dose and the mean Pd1/2 of this decline of pharmacodynamic effect was observed to be 135 h. However, no measurable amount of AT or NT was present after 84 h and the mean elimination plasma half-life (t1/2) of AT and NT were 37.7 and 38.9 h, respectively. (In this study, pharmacokinetic parameters of NT were directly related with those of AT.) Prolonged pharmacodynamic effect of this drug after discontinuation should be borne in mind in order to avoid drug interactions and autonomic complications, especially after overdosage. Pd1/2, as assessed by DTS, correlated directly with the t1/2 (r = 0.91) and inversely with the plasma clearance rate (r = 0.60) of NT. DTS test can be used as an alternative technique to assess the biological activity of a drug which inhibits noradrenaline reuptake mechanism and/or blocks alpha-adrenoceptors at the peripheral neuronal sites, especially, where facilities to measure plasma concentrations of such drugs are limited.

Adult↗
PubMed1980

Complications of baclofen overdosage.

A 39-year-old female patient who had been receiving 30 mg of baclofen daily for 5 months was admitted to the hospital about 12 hr after overdose of this drug (450 mg). On admission, she was comatose, flaccid, and in respiratory failure. Later she developed muscle twitchings and had several epileptic fits. She was treated symptomatically and became conscious within 36 hr. However, approximately 65 hr after the overdose she developed sinus tachycardia which was successfully treated with oral propranolol. Plasma concentrations, as measured on days 2 and 3, were within the therapeutic range but the elimination half-life was prolonged.

Adult↗
PubMed1980

Hospital bed occupancy due to drug-related problems.

The number of patients admitted for drug-related problems and the duration of inpatient treatment required primarily for drug reactions and/or related problems during the period 1 October to 31 December 1979 were studied in one of the three general medical units of a district general hospital. 93% of all patients were admitted as emergencies either through the casualty department or at the their own general practitioner's request. Acute self-poisoning (9.9%) and other drug-related problems (8.8%) were, respectively, the third and fifth most common causes of hospital admission. These two conditions jointly (all drug-related problems) appeared to be the second most common cause and accounted for 18.7% of hospital admissions. The mean duration of hospitalization in patients with drug-related problems, excluding self-poisoning, was approximately 8 days. This was almost identical to hospital bed occupancy due to bronchopulmonary diseases (8.3 days) and complications of diabetes mellitus (8.4 days).

Adolescent↗
PubMed1979

Pharmacokinetics and pharmacodynamics of amitriptyline in depression.

1. The therapeutic effect and pharmacokinetics of amitriptyline were assessed in thirty-five patients suffering from primary depressive illness during inpatient treatment. 2. Contrary to our previous study, no significant correlation was obtained between the plasma concentrations of amitriptyline, nortriptyline or total tricyclics with Hamilton rating score at 6 weeks or percentage improvement after 6 weeks treatment. 3. There was also no correlation with the plasma concentrations of tricyclics with the corrected subjective side-effects score. 4. A linear correlation (rs = 0.80; p less than 0.001) was observed between the plasma concentration of nortriptyline and decreased tyramine sensitivity, an index of noradrenaline reuptake blocking effect. 5. The corrected side-effect score during the trial correlated (r = 0.64; p less than 0.001) with Hamilton rating score at week 6, i.e. the patients who complained of more side-effects had less clinical benefit during amitriptyline therapy.

Amitriptyline↗
PubMed1978

[Study report on the lack of interaction between mianserine and noradrenaline in man].

Tricyclic antidepressants are known to potentiate the increase in blood pressure caused by noradrenaline. Five depressive patients were given intravenous noradrenaline before and after 2--4 weeks of treatment with Org GB 94 (Tolvin). The dose of noradrenaline was increased until a rise of 30 mmHg in systolic blood pressure occurred. No evidence of interaction between Org GB94 and noradrenaline was found. The implications of this are discussed.

Antidepressive Agents, Tricyclic↗