PubMed Health⌕ Search

Biomedical subjects

Lingtak-Neander Chan

Publications and source records attributed to Lingtak-Neander Chan.

5 recordsLinked to original sources
PubMed2006

Evaluation of a sex-based difference in the pharmacokinetics of digoxin.

STUDY OBJECTIVE: To determine whether a sex-based difference in digoxin pharmacokinetics exists in patients receiving long-term digoxin therapy for chronic heart failure or atrial fibrillation. DESIGN: Single-center, retrospective review of medical records. SETTING: University-based teaching hospital and outpatient clinic. PATIENTS: Sixty-seven adults (32 men, 35 women) with chronic heart failure or atrial fibrillation who were receiving digoxin therapy. MEASUREMENTS AND MAIN RESULTS: Serum digoxin concentrations and daily digoxin doses were obtained from patients' medical records. Daily doses were adjusted for patients' actual and ideal body weight and body mass index (BMI). The ratio between the serum digoxin concentration and each of the adjusted daily doses of digoxin was compared between men and women. The mean +/- SD serum digoxin concentration was 0.85 +/- 0.51 ng/ml for men compared with 1.02 +/- 0.51 ng/ml for women. Mean +/- SD unadjusted doses of digoxin were 0.180 +/- 0.063 and 0.164 +/- 0.059 mg/day for men and women, respectively; the difference was not statistically significant. Ratios of serum digoxin concentration to daily digoxin doses did not differ by sex when doses were estimated with actual or ideal weight. Only the ratio of the digoxin concentration to the BMI-adjusted dose was significantly different between men and women (0.14 +/- 0.09 and 0.19 +/- 0.11, respectively, p<0.05). CONCLUSION: Sex-based differences in digoxin pharmacokinetics were absent when actual or ideal body weight was used. However, the ratio of serum digoxin concentration to daily digoxin dose adjusted for BMI differed by sex. Because digoxin is distributed to lean body mass, use of the BMI could have overadjusted body weight, leading to inaccurate pharmacokinetic assumptions and calculations. The pharmacokinetics of digoxin do not appear to differ by sex.

Aged↗
PubMed2004

Nutritional support in acute renal failure.

PURPOSE OF REVIEW: Acute renal failure is commonly present in patients with sepsis, shock, trauma, burn injury, or multi-organ dysfunction syndrome. Acute renal failure is an independent risk factor contributing to increased hospital mortality. The major complications associated with acute renal failure include metabolic derangement and protein catabolism. The purpose of this article is to review the literature between 2001 and December 2003, to determine whether newer studies have provided a better understanding of the optimization of caloric and protein delivery to critically ill patients with acute renal failure receiving continuous renal replacement therapy. RECENT FINDINGS: Continuous renal replacement therapy is now widely used in the intensive care unit to manage patients with acute renal failure, because it is better tolerated than intermittent hemodialysis by patients who are hemodynamically unstable. Although continuous renal replacement therapy is highly efficient in the removal of toxins and metabolic wastes, it may also lead to an excessive loss of nutrients, which include intact protein and amino acids. Data describing the optimal nutritional support regimen for patients receiving continuous renal replacement therapy are very limited. SUMMARY: The results and findings from this review may help clinicians to individualize caloric and protein delivery for patients with acute renal failure. The ultimate goal is to tailor the regimen towards the needs of each individual patient in order to maximize the benefit of nutritional support, in the hope of improving patient survival.

Acute Kidney Injury↗
PubMed2002

Drug-nutrient interaction in clinical nutrition.

Drug-nutrient interactions have been recognized for decades. It is known that improper management of some of these interactions may lead to therapeutic failure or cause serious adverse effects to the patients. While most of the known drug-nutrient interactions involve changes in oral bioavailabilities and absorption of the offending compounds, recent investigations suggest that different mechanisms also exist. A mechanism-derived classification system for drug-nutrient interactions has only recently been developed. This system should facilitate the future research and development of practice guidelines in the identification and management of important interactions.

Biological Availability↗
PubMed2002

Use of thrombolytic therapy to treat heparin-refractory pulmonary embolism in a menstruating patient.

A 26-year-old woman developed an acute pulmonary embolism at the beginning of her menstrual cycle and was admitted to the hospital. When she failed initial standard treatment with heparin, the only other therapeutic option was a thrombolytic agent such as recombinant tissue plasma activator (rt-PA). Use of these agents, however, carries a large risk of major bleeding complications and brings concern of increased menstrual blood flow and duration. A literature search of the use of thrombolytic agents in menstruating patients found only limited reports. Our patient responded well to rt-PA therapy Her hemoglobin levels remained stable, and she experienced no bleeding complications. Careful monitoring and caution are recommended when administering thrombolytic agents to menstruating patients.

Adult↗