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Biomedical subjects

K L Paul

Publications and source records attributed to K L Paul.

7 recordsLinked to original sources
PubMed1998

Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms.

OBJECTIVE: To document a case of serotonin syndrome associated with venlafaxine and fluoxetine that did not involve a monoamine oxidase inhibitor, and to examine the multiple factors, including pharmacodynamic and pharmacokinetic interactions, that likely caused this adverse drug reaction (ADR). CASE SUMMARY: A 39-year-old white woman with depression and panic attacks was being treated with fluoxetine, trazodone, clonazepam, and cimetidine. After fluoxetine and clonazepam were abruptly discontinued, venlafaxine and lorazepam were started. Within 24 hours, she developed diaphoresis, tremors, slurred speech, myoclonus, restlessness, impaired thinking, and diarrhea. This constellation meets Sternbach's criteria for serotonin syndrome. DISCUSSION: The possible contributors to this ADR are discussed, including a single drug effect (e.g., an idiosyncratic reaction to venlafaxine), a pharmacokinetic interaction, a pharmacodynamic interaction, a combined pharmacokinetic-pharmacodynamic interaction, and the patient' s panic disorder. CONCLUSIONS: As more serotonergic drugs are developed and used for psychiatric disorders, frequently in combination or close temporal proximity, clinicians must be aware of and consider the factors that may increase the risk of patients experiencing serotonin syndrome.

Adult↗
PubMed1989

To be or not to be: the suicidal patient.

Depression is a common condition in the practice of most physicians. Some depressed patients are prone to suicide, many ambivalent about it. The SAD PERSONS scale may be helpful for the physician in assessing risk. Because of the ambivalence, it is important that an authority figure-physician, friend, family member- not fail to recognize the risk and unthinkingly sanction a destructive act.

Adult↗
PubMed1982

Brief family therapy utilizing graph analysis.

Problems in child-rearing can be quickly analyzed and solutions recommended by using a graph to spot key problem areas. The strictness or permissiveness of each parent is plotted on the horizontal axis, and stress is plotted on the vertical axis. Patterns are readily identified by noting the basic positions of the parents and their subsequent shifts as stress increases.

Child↗
PubMed1979

Hemoglobinuria and hematuria: accuracy and precision of laboratory diagnosis.

Five methods of assessing blood in urine were studied and compared: sedimentation count, hemacytometry, "Clini-lab" reagent strip and "N-Multistix" and "ChemStrip-8" dipsticks. The minimum sensitivity of two commercially available urine dip-stick procedures for blood was established. The study includes method association, assay variation among and within technologists, accuracy, precision, and sensitivity. Our results demonstrate generally poor association between results by the dip-stick procedures and the hemacytometer or sedimentation count. Results by the last two procedures also showed very poor association with each other.

Clinical Laboratory Techniques↗
PubMed1978

Urinary nitrite and urinary-tract infection.

Two dipstick procedures and an automated quantitative urinary nitrite assay were used to study nitrite in 786 samples of urine submitted to the bacteriology laboratory for routine culture and sensitivity testing. Many samples that had more than 100,000 nitrite-reducing organisms/ml and no detectable nitrite were studied. Limited nitrate concentration in urine was not a significant cause of false-negative nitrite results. However, in some urine samples nitrite added in vitro was lost during a four-hour incubation in vitro at 37 C in the presence of more than 100,000 nitrite-reducing organisms/ml. Ascorbic acid, abnormal amounts of urobilinogen, and urinary pH below 6.0 are all possible causes of false-negative nitrite determinations.

Autoanalysis↗
PubMed1971

Effects of hydrostatic pressure and temperature on the uptake and respiration of amino acids by a facultatively psychrophilic marine bacterium.

Studies of pressure and temperature effects on glutamic acid transport and utilization indicated that hydrostatic pressure and low temperature inhibit glutamate transport more than glutamate respiration. The effects of pressure on transport were reduced at temperatures near the optimum. Similar results were obtained for glycine, phenylalanine, and proline. Pressure effects on the transport systems of all four amino acids were reversible to some degree. Both proline and glutamic acid were able to protect their transport proteins against pressure damage. The data presented indicate that the uptake of amino acids by cells under pressure is inhibited, which is the cause of their inability to grow under pressure.

Amino Acids↗