PubMed Health⌕ Search

Biomedical subjects

L E Hopkins

Publications and source records attributed to L E Hopkins.

9 recordsLinked to original sources
PubMed1990

Acylated plasminogen-streptokinase activator complex: a new approach to thrombolytic therapy.

Acylated plasminogen-streptokinase activator complex (APSAC; antistreplase) is an inactive complex of human plasminogen and streptokinase. When it is injected, a controlled deacylation of the catalytic center occurs, activating the complex so that thrombolysis may begin. This process extends the half-life of streptokinase, allowing for 4-6 hours of fibrinolytic activity. Anistreplase has demonstrated equivalent efficacy to intracoronary streptokinase with regard to reperfusion rates in acute myocardial infarction. In addition, patients have shown a 56% reduction in mortality at 28 days with anistreplase compared to heparin. The adverse effect profile of anistreplase includes minor bleeding and hematoma formation at the site of venipuncture, hypotensive and bradycardic episodes, arrhythmias, facial flushing, fever, and rarely, allergic reactions. Serious bleeding reactions are uncommon, with the frequency of cerebrovascular accident reported at 0.4-0.6%. The special advantage of anistreplase is its administration as a 30-U intravenous bolus injected over 5 minutes, eliminating the need for long infusions and increasing the ease of administration. Based on its efficacy and ease of administration, anistreplase may become the drug of choice in the emergency treatment of acute myocardial infarction.

Anistreplase↗
PubMed1989

Use of a proprietary database to examine lengths of hospital stay of patients who received drug therapy for acute myocardial infarction.

Lengths of hospital stay of patients who received streptokinase therapy and of patients who received conventional i.v. heparin or nitroglycerin therapy for acute myocardial infarction (AMI) were determined using the International Health Services, Ltd., (IHS) database. Patients in all IHS-participating hospitals who had received streptokinase in conjunction with an AMI between October 1985 and September 1986 were identified from the database. Diagnosis-related groups (DRGs) 121 and 122 were found to contain patients who potentially could serve as the study population. Based on examination of length-of-stay data from the medical record database at the study hospital, the IHS study population was refined to include AMI patients 75 years of age or younger with stage 2 disease (intermediate severity) in DRG 121 or stage 1 disease (least severe) in DRG 122 and a length of stay of at least seven days. Patients who met those criteria and had been treated with heparin, nitroglycerin, or both served as a control group. The mean length of stay of patients treated with streptokinase (113 patients) was significantly shorter than that of patients treated with heparin (1332 patients) or nitroglycerin (752 patients). Patients treated with streptokinase had a length of stay 1.2 days shorter than patients treated with heparin and 1.3 days shorter than patients treated with nitroglycerin. The database proved to be useful for determining lengths of patient stay associated with thrombolytic and conventional medical therapy for AMI. Thrombolytic therapy may be a cost-effective treatment for AMI because length of stay may be somewhat shorter.

Data Collection↗
PubMed1979

Management of neonatal narcotic abstinence utilizing a phenobarbital loading dose method.

A group of eighteen infants which experienced the neonatal abstinence syndrome due to prenatal maternal use of methadone responded adequately to phenobarbital with control of symptoms. By administering the phenobarbital as an initial single loading dose and closely monitoring the blood levels, maintenance dosing could easily be adjusted for variables in infant metabolism and pharmacologic effect. By use of a multifactorial abstinence scoring system, the pharmacologic effects on clinically observed abstinence symptomatology could be closely monitored and correlated with the blood levels. Serum levels of 20-30 mcg/ml were adequate to control all but one infant. Tapering the blood level of phenobarbital to 10-12 mcg/ml and observing no scores over 8 for 72 hours identified the place in time where abstinence was no longer significant and the infant could be discharged without medication.

Administration, Oral↗