Biomedical subjects
M Viukari
Publications and source records attributed to M Viukari.
[Upsetting experience results in diagnostic problem].
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[Beta blockers, calcium channel blockers and psyche].
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[Are behavioral disorders in children and adolescents actually post-traumatic stress disorders?].
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[Hallucinations in hysterical psychosis].
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[Management of paranoid symptoms in the elderly].
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[Acute confusion in geriatric patients].
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Psychosis-like absence status of elderly patients: successful treatment with sodium valproate.
Absence status and psychosis-like behaviour and continuous spike-and-wave EEG activity in two elderly women is reported. Once the correct diagnosis was made, the patients were successfully treated with sodium valproate. Differential diagnosis between absence status and psychotic syndromes is emphasised.
Low doses of brotizolam and nitrazepam as hypnotics in the elderly.
0.125 mg brotizolam and 2.5 mg nitrazepam proved to be equipotent in promoting and maintaining sleep in 29 elderly patients used to long-term hypnotics. These drugs were superior to placebo and they were excellently tolerated. The drugs were administered in a random order, double-blind, for 7 nights each.
Diazepam, promethazine and propiomazine as hypnotics in elderly inpatients.
Diazepam 5 mg, promethazine 25 mg, propiomazine 25 mg, and placebo as sleeping aids were studied in 40 elderly inpatients. The drugs were administered in a random order, double-blind, on 21 nights. All active drugs were found effective in the mentally normal elderly, but in the psychogeriatric group of 20 patients, only propiomazine very significantly reduced the number of nocturnal awakenings and only diazepam almost significantly shortened the initial sleep latency, although duration of sleep was prolonged in both groups. There was neither loss of efficacy of the trial drugs nor rebound on withdrawal. Psychomotor skills and serum prolactin levels remained unaffected.
Flunitrazepam and nitrazepam as hypnotics in psychogeriatric inpatients.
The efficacy and clinical effects of flunitrazepam (1 mg) and nitrazepam (5 mg) as somnifacients were studied in 37 psychogeriatric inpatients. Each drug was administered in a double-blind manner to randomized groups of patients for 14 nights. Compared with placebo, both benzodiazepines proved to be effective in inducing and maintaining sleep. Although both drugs were well tolerated, insomnia resulted when each was withdrawn.
Tolerance and serum levels of haloperidol during parenteral and oral haloperidol treatment in geriatric patients.
Eleven geriatric chronic psychotic hospital patients were treated with monthly intramuscular haloperidol decanoate injections for 5 months. The first and second haloperidol decanoate dose was 20 times and thereafter 15 times the "optimal" oral haloperidol dose. The serum haloperidol concentrations were fairly stable during the whole month following parenteral administration. After the second and third injection the concentration was about twice as high as during oral treatment. No clinically significant changes were established in routine haematological or biochemical laboratory tests studied during the trial. No significant changes in serum prolactin levels were observed after parenteral haloperidol compared to the levels during oral treatment. No local or systemic side effects were observed during the trial. The psychiatric status of the patients was fairly constant during the whole study. Haloperidol decanoate was thus shown to be therapeutically effective and it can be administered safely to geriatric patients.
Haloperidol, thioridazine and placebo in mentally subnormal patients-serum levels and clinical effects.
A randomized cross-over trial was conducted in 30 restless mentally subnormal patients by increasing the dosage of haloperidol from 10 to 60 mg and that of thioridazine from 100 to 600 mg daily. The clinical effects of drug holidays on placebo and serum drug levels were also examined. There were more relative drug-responders than nonresponders or negative responders. Correlation between clinical response and drug serum levels was poor, probably owing to the heterogeneity of disorders treated. Mesoridazine and other metabolites had 5-6 times higher serum levels than the parent compound, and relatively high serum levels are achieved already with moderate doses. The observed differences between haloperidol and thioridazine treatment were surprisingly few. Serum cholesterol was higher (P less than 0.05) at the end of thioridazine than of the haloperidol administration.
Pharmacokinetics of diazepam administered rectally in geriatric patients: comparison of suppositories with rectal tubes in a cross-over study.
The pharmacokinetics of diazepam administered as suppositories or as a solution in rectal tubes were compared in six geriatric hospital patients. A single dose of 10 mg was administered in a cross-over study with a one week interval. There was no statistically significant difference in the bioavailability, the mean maximum serum concentration or the time of achievement of the maximum with these preparations. However, the peak serum concentration was somewhat higher with suppositories but the absorption was somewhat faster via rectal tubes. The serum N-desmethyldiazepam concentration increased during the whole 24 hour observation period, there was no difference between the preparations. Our results are in good agreement with most studies of the pharmacokinetics of diazepam. The basal substance of the suppository is of the utmost importance to the absorption of diazepam. The rectal tube for administration of diazepam did not have any advantage over the optimally formulated (a mixture of macrogols) suppository in geriatric patients. In fact, the use of rectal tubes is more expensive, the tube may not be completely emptied, and the solution may not be completely retained in the rectum.
Plasma neuroleptic and prolactin levels in mentally retarded patients.
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Efficacy and side effects of chloral hydrate and tryptophan as sleeping aids in psychogeriatric patients.
The effects of placebo, L-tryptophan 3 g, and chloral hydrate 500 mg on sleep were studied in 19 nonpsychotic, mildly demented, geriatric inpatients. Only chloral hydrate was more effective in inducing and maintaining sleep than placebo. Neither chloral hydrate not L-tryptophan had any significant side effects, but withdrawal of chloral hydrate was associated with insomnia.
Efficacy and side effects of lorazepam, oxazepam, and temazepam as sleeping aids in psychogeriatric inpatients.
The efficacy and side effects of 2 mg of lorazepam, 30 mg of oxazepam, and 20 mg of temazepam as sleeping aids were investigated in 20 psychogeriatric inpatients. The drugs were administered in a random order, double-blind, for 7 night each. All of these short half-life benzodiazepines proved efficacious in maintaining sleep. None of them reduced initial sleep latency. Oxazepam and to a lesser degree temazepam induced withdrawal insomnia during the first night after the treatments. The withdrawal of lorazepam induced a delayed but prolonged insomnia in 3 patients. Both lorazepam and oxazepam had muscle relaxant side effects after awakening.