Biomedical subjects
N H Leeds
Publications and source records attributed to N H Leeds.
Effect of food on the bioavailability and pattern of release of a sustained-release theophylline tablet.
The effect of food on the bioavailability, time to peak level, and pattern of release of a sustained-release theophylline preparation was examined in six normal volunteers. The average bioavailability for the 100- and 300-mg tablets was 98 +/- 0.03% (S.E.M.). This is consistent with previously published data. Food decreased measured theophylline concentration during the first 4 hours for the 100-mg tablets and at the fourth-hour sample following the 300-mg tablets. The decreased rate of absorption resulted in a shift of the absorption curve to the right with a delay in the time to peak level. Peak serum concentrations for tablets given with a meal occurred 6 hours after the 100-mg tablets and 8 hours after the 300-mg tablets, as opposed to 4 and 6 hours, respectively, for tablets in the fasting state. The release pattern of the theophylline preparation approximated zero-order kinetics for all fasting and food treatments.
The effect of erythromycin on theophylline pharmacokinetics at steady state.
We compared steady-state theophylline pharmacokinetics in 13 healthy adults before and immediately after erythromycin therapy. All subjects received a five-day course of oral aminophylline 3 mg/kg every six hours prior to and during a five-day course of oral erythromycin stearate (1 g daily). Each subject acted as his own control. Multiple serum samples were collected over ten hours following the last dose of aminophylline during both the control and experimental phases of the study. Erythromycin did not significantly affect theophylline clearance (P greater than 0.70), elimination (P greater than 0.75), or volume of distribution (P greater than 0.30). We found no evidence of a pharmacokinetic interaction between theophylline and erythromycin at steady state. Worsening pulmonary function may be responsible for altered theophylline pharmacokinetics in patients coincidentally receiving erythromycin.
Moxalactam (Moxam) in the treatment of experimental staphylococcal endophthalmitis.
We investigated the intraocular penetration, retinal toxicity, clearance from the vitreous, and antibacterial activity of moxalactam (Moxam), a new third-generation cephalosporin with activity against aerobic and anaerobic gram positive organisms and many gram negative organisms. Seventy-four albino rabbits were used. Subconjunctival injection yielded therapeutic aqueous and vitreous levels for all hours studied. Intraocular penetration following single dose intravenous and intramuscular administration was poor. Two mg injected into the vitreous produced rare focal retinal toxicity. Eleven of the 11 eyes receiving intravitreal injections of 2 mg moxalactam eight hours after inoculation with S. aureus were sterile and free of morphologic changes. Moxalactam appears to be a potent broad spectrum antibiotic with a low degree of toxicity to rabbit retinal tissue.
Implementation of a self-directed pharmacy technician training program.
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Monitoring salivary theophylline levels.
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Drug regimen review in skilled nursing facilities by consulting clinical pharmacists.
The organization and operational methods of clinical pharmacists providing contractual pharmaceutical services in skilled nursing facilities (SNFs) are described, and the use of a model toidentify drug therapy problems is analysed. A group of clinical pharmacists incorporated as Clinical Pharmacy Consultants (CPC) provided consultative services through contractual agreements with pharmacy vendors or SNF administrators. Using a drug regimen review model designed by CPC, the consulting pharmacists reviewed 13,081 medical charts at 10 SNFs. Of the reviews, 928 (7.1%) indicated potential or real drug therapy problems; on an annual basis this corresponds to approximately eight drug therapy problems per 10 beds per year in an SNF. About 60% of the problems could be attributed either to prescribing of medication with no documented indication (23.9%) or to lack of objective data for monitoring drug therapy effectiveness (34.6%). Because these problems are related to disease state management, it was concluded that consulting clinical pharmacists could help to improve patient care in SNFs, primarily through drug therapy review and staff consultation.
Relative bioavailability and release pattern of whole and halved sustained-release theophylline tablets.
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