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M T Reed

Publications and source records attributed to M T Reed.

7 recordsLinked to original sources
PubMed1990

Sympathomimetics for acute severe asthma: should only beta 2-selective agonists be used?

Sympathomimetics have become a mainstay of the treatment of acute asthma. Aerosolization of sympathomimetics provides as great or greater bronchodilation in acute severe asthma with fewer systemic effects than parenteral therapy. Despite the broncho-selectivity achieved with this route of administration, cardiostimulation remains the major, dose-limiting factor in the safe use of sustained, high-dose therapy with these agents. This article reviews the pharmacology, adverse effects, and toxicities of selected beta agonists, as well as clinical studies relevant to the question posed in the title. Although the ideal study to answer this question has not yet been performed, the authors feel that available evidence supports the preferential use of selective beta 2 agonists in patients with acute, severe asthma who will require high doses of beta agonists.

Acute Disease↗
PubMed1988

Stability of procainamide hydrochloride in neutralized 5% dextrose injection.

The stability of procainamide hydrochloride in neutralized 5% dextrose injection was studied. Sixty-four admixtures were prepared by adding either 2 mL (for 0.4% admixtures) or 4 mL (for 0.8% admixtures) of procainamide hydrochloride to 250 mL of 5% dextrose injection in plastic containers. The pH of 32 of these admixtures (16 of each type) was adjusted to 7.5. These 32 admixtures represented the neutralized group, and the remaining 32 represented the control group. The admixtures were stored at either 23-25 degrees C (room temperature) or 5 degrees C (refrigeration) for 24 hours. Procainamide hydrochloride concentrations in each sample were determined by high-performance liquid chromatography immediately after the admixtures were prepared and at various intervals during storage. Procainamide concentrations decreased over time in 5% dextrose injection. The decrease was significantly less for admixtures in neutralized 5% dextrose injection, those stored under refrigeration, and those with an 0.8% concentration of drug. Decreases in procainamide hydrochloride concentrations in the control admixtures might have been caused by procainamide-dextrose complexation. Initial concentrations of procainamide hydrochloride in 5% dextrose injection can be adequately maintained over a 24-hour storage period by neutralizing the 5% dextrose injection or storing the admixture at 5 degrees C. However, because it is impractical to maintain the necessary temperature condition during a 24-hour infusion, neutralization might be the most viable alternative when extended stability of procainamide hydrochloride in 5% dextrose injection is required.

Chemistry, Pharmaceutical↗
PubMed1986

Abnormal thallium 201 scintigraphy during low-dose vasopressin infusions.

Thallium 201 (201Tl) myocardial scans were obtained in 16 patients just prior to the discontinuation of a vasopressin infusion (.1 to .2 units/min) administered for the treatment of upper gastrointestinal bleeding. Repeat scintigraphy was performed two to three hours after the vasopressin was stopped. Eleven of the 16 patients (69 percent) demonstrated areas of decreased myocardial 201Tl uptake that resolved after the infusion was stopped. Heart rate-blood pressure product was significantly lower at the time of the second scan. Autopsies were secured in three of 11 scan-positive patients: one had severe coronary artery obstruction, one nonsignificant disease, and another had normal coronary arteries. Vasopressin, even at low doses, can induce abnormalities in myocardial perfusion that are probably mediated by a direct effect on the coronary circulation. They are usually not detectable by routine monitoring techniques and conceivably form the basis for the cardiovascular morbidity associated with the use of this agent.

Adult↗
PubMed1986

Short-course drug therapy for tuberculosis.

The cost, patient compliance considerations, and toxicity of short-course chemotherapy (SCC) and conventional 18- to 24-month treatment regimens for pulmonary tuberculosis are compared; studies of the efficacy of SCC regimens are evaluated; and the future of SCC in the United States is examined. SCC is defined as treatment for nine months or less. A definite advantage of SCC over conventional therapy in terms of cost, patient compliance, or adverse effects has not been established. A series of studies conducted by the East African-British Medical Research Council documented the efficacy of various six-month, multiple-drug regimens that contain rifampin and verified the sterilizing activity of pyrazinamide during the first two months of therapy. The studies of the Hong Kong Chest Service and British Medical Research Council documented the efficacy of several intermittent drug regimens. Acceptable relapse rates were achieved with streptomycin, isoniazid, and pyrazinamide given two or three times a week for four or six months, preceded by a two-month, multiple-drug, daily regimen, and various four-drug, pyrazinamide-containing intermittent regimens. The benefit of pyrazinamide in reducing the relapse rate with SCC was confirmed by studies of the British Thoracic and Tuberculosis Association. Few studies of SCC have been conducted in the United States. Treatment practices in the United States are becoming more uniform, and SCC is being used more frequently for uncomplicated pulmonary tuberculosis. SCC will probably be used more widely in the future. Current guidelines of the Centers for Disease Control recommend treatment for nine months with isoniazid and rifampin, plus ethambutol in areas where resistance to isoniazid is common. In vitro data suggest that the addition of pyrazinamide may be more effective, but clinical experience with this drug in the United States is limited.

Antitubercular Agents↗
PubMedDate not supplied

The dependent nurse.

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Alcoholism↗