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Biomedical subjects

L K Garrettson

Publications and source records attributed to L K Garrettson.

At least 37 records · Page 2Linked to original sources
PubMed1984

Direct and indirect chemical exposure in children.

Like adults, children are at risk from chemicals in the environment; unlike adults, the cause of their risk is due to developmental factors. Because organs such as the brain are developmentally incomplete in children, there is the potential for effects on maturation that are not seen in the adult. Environmental and occupational safety considerations need to include children because of the potential for toxins to be transported--for example, via clothing and the air we breathe.

Age Factors↗
PubMed1984

Camphor toxicity: development of a triage strategy.

Camphor remains in over 950 products listed in Poisindex. To provide triage guidelines for gastric decontamination and referral, we reviewed all camphor ingestions estimated to be 2 mg/kg or greater reported to U. VA (1980-83) and to M.C.V. (1982-83). Seventy-three patients (90%) remained asymptomatic, 3 (4%) developed minor symptoms, and 5 (6%), all ingesting over 59 mg/kg, developed major symptoms. There were no deaths. (table; see text) A literature review of 63 evaluable cases revealed 6 deaths; the mean fatal dose was 199 mg/kg (range 64-570, median 113). Based on these data, we manage asymptomatic patients ingesting camphor at less than 10 mg/kg by observation only 10-30 mg/kg at home with 1 g/kg activated charcoal or emesis, and over 30 mg/kg by gastric decontamination plus referral.

Camphor↗
PubMed1975

Decreased serum salicylate concentrations in children with rheumatic fever treated with antacid.

To determine if the common practice of giving antacids to patients on salicylate therapy has an effect on serum salicylate concentrations, we gave a widely used antacid, aluminum and magnesium hydroxide, and aspirin concomitantly to three children with rheumatic fever. Urinary pH increased appreciably, and serum salicylate concentrations decreased by 30 to 70 per cent. In five healthy adult volunteers concomitant administration of antacid had no effect on the bioavailability of aspirin. Pharmacokinetic analysis revealed that the antacid-induced decrease of serum salicylate concentrations was due to increased renal clearance of salicylate caused by the rise in urinalry pH.

Adult↗
PubMed1975

Fetal acquisition and neonatal elimination of a large amount of salicylate. Study of a neonate whose mother regularly took therapeutic doses of aspirin during pregnancy.

The purpose of this study was to determine the amount of salicylate acquired by a newborn infant from a mother who took 6.5 gm of aspirin a day during her entire pregnancy, and to characterize the kinetics of salicylate elimination by the infant. This healthy female infant was born with a salicylic acid concentration of 25 mg/100 ml plasma and 75 mg/kg body weight. The drug was eliminated during the first 5 days of life, primarily in the form of salicyluric acid. Salicylate elimination was relatively slower than in normal adults, but more rapid than in newborn infants of mothers who had taken only one small dose of aspirin shortly before delivery. The apparent in vivo KM and Vmax for salicylurate formation, on a body weight basis, were at the adult level. The slower elimination of salicylate (relative to adults) by the infant was due to immaturity of the glucuronidation and renal excretory pathways.

Arthritis↗
PubMed1975

Diphenylhydantoin elimination kinetics in overdosed children.

Diphenylhydantoin (DPH) elimination was studied in 4 overdosed children who presented with serum concentrations ranging from 44 to 76 mg/l. Serum was assayed for DPH and urine was assayed for both DPH and 5-(p-hydroxyphenyl)-5-phenylhydantoin (HPPH). The serum and urine data were subjected to simultaneous computer nonlinear regression analysis using a one-compartment pharmacokinetic model, which accounts for much of the known disposition kinetics of DPH. Computed values for the apparent in vivo Michaelis-Menten constants, K-M and V max, were compared with values derived from data in the literature for normal adult subjects. A trend toward relatively lower K-M and higher V max/K-M values was seen in children. Patients with higher V max values had greater urinary excretion rates of HPPH which, at high serum levels of DPH, were relatively constant except for an apparent diurnal rhythm. The time of onset of DPH toxicity in the children was related to the magnitude by which the rate of DPH administration exceeded the V max values.

Child↗
PubMed1975

Distribution of salicylate between neonatal and maternal serum at diffusion equilibrium.

The post-distributive neonatal:maternal plasma salicylate concentration ratio following salicylate administration to the mother before delivery is appreciably higher than unity. The protein binding of salicylate and the albumin concentration in one such plasma pair were considerably higher in the neonatal than in the maternal plasma. Equilibrium dialysis of neonatal plasma or serum from 6 newborn infants against that of their mothers produced a neonatal: maternal salicylate concentration ratio above unity in all cases even if the albumin concentration in the neonatal serum did not exceed that in the maternal serum. However, there was a strong correlation between the neonatal:maternal concentration ratios of salicylate and albumin. These observations demonstrate that conclusions concerning the distribution of a drug across the placenta in relation to its plasma protein binding characteristics must be based on the results of binding studies with plasma or serum from neonates and their mothers, and not from other adult subjects.

Dialysis↗
PubMed1975

Phenobarbital disposition in the neonate.

The disposition of phenobarbital in premature infants was assessed by repeated measurement of the serum concentration of unmetabolized drug and the urinary excretion of both phenobarbital and its metabolite, p-hydroxyphenobarbital. Serum elimination rates did not adequately reflect the elimination of total body phenobarbital. A prolonged distributive phase is postulated. The elimination rate of p-hydroxyphenobarbital was constant, suggesting capacity limited kinetics. Slow elimination in serum concentrations which remained in the therapeutic range for several days suggests that short courses of therapy may have prolonged effect in the newborn premature infant.

Humans↗