PubMed Health⌕ Search

Biomedical subjects

P Ertama

Publications and source records attributed to P Ertama.

18 recordsLinked to original sources
PubMed1992

[Interactions between lithium/rubidium and six muscle relaxants. A study on the rat phrenic nerve-hemidiaphragm preparation].

The cumulative concentration-response curves for alcuronium, metocurine, d-tubocurarine, suxamethonium, pancuronium and vecuronium alone or in combination with lithium or rubidium were measured using indirectly evoked twitch tension in the isolated rat phrenic nerve-hemidiaphragm preparation. In the experiments with lithium and rubidium, 10% and 2% of the sodium ions (118 mmol/l) of Krebs solution were replaced by lithium (11.8 mmol/l = 0.082 g/l) or rubidium (2.36 mmol/l = 0.202 g/l) ions, respectively. At these concentrations, neither lithium nor rubidium alone affected twitch tension. Lithium led to a statistically significant enhancement of the myoneural blocking effects of suxamethonium, pancuronium and vecuronium, but not of the other myoneural blocking drugs. Rubidium behaved similarly to lithium, except that enhancement of the effect of vecuronium was not statistically significant. At higher concentrations, lithium and rubidium alone depressed twitch tension in a dose-dependent manner. Neither myoneural blocking drugs nor lithium and rubidium affected the directly evoked twitch tension. It is concluded that myoneural blocking drugs, especially the newer ones, should be used with caution in patients receiving lithium or other alkali metal therapy as it is not known what interactions may arise.

Animals↗
PubMed1982

A double-blind clinical trial comparing alcuronium with pancuronium.

Alcuronium and pancuronium were compared as muscle relaxants in a randomized and double-blind trial in routine clinical circumstances during combined balanced anesthesia in 40 female patients. The course of endotracheal intubation at 2 min. was statistically significantly better (p less than 0.001) in the pancuronium group than in the alcuronium group. There were no differences between the two groups regarding relaxation, maintenance of anesthesia and postoperative recovery. In the pancuronium group the systolic blood pressure was significantly higher than in the alcuronium group at 2 minutes after induction (p less than 0.01), at 2 minutes after intubation (p less than 0.05) and before incision (p less than 0.05). Also the diastolic blood pressure was significantly higher in the pancuronium group at 2 minutes after induction (p less than 0.001), before incision (p less than 0.01) and at 2 minutes after incision (p less than 0.05) than in the alcuronium group. Thus alcuronium is preferable when hypertensive episodes are to be avoided whereas pancuronium would be more suitable when hypotension can be expected.

Adult↗
PubMed1978

Residual nitrous oxide in operating room personnel.

The concentrations of nitrous oxide in the blood and end-tidal air of 10 operating-room nurses were assayed by gas chromatography immediately and 1, 2, 5, and 21 h after 3 hours of exposure to an average of 380 ppm of nitrous oxide in operating-room air. In the second trial the nurses' end-tidal air concentrations of nitrous oxide were assayed on Monday, Wednesday, Friday and Sunday morning, and on Sunday afternoon and evening to reveal a possible accumulation of nitrous oxide during a routine week. After cessation of exposure there was a rapid decrease in the blood concentrations of nitrous oxide during the first hour (from 153 +/- 110 microgram/1 to 48 +/- 20 microgram/l at 1 h; means +/- s.d.), followed by a slower decrease. Small amounts (mean +/- s.d.: 18 +/- 6 microgram/l) of nitrous oxide were still measurable on the following morning 21 h after exposure. At 2 or 5 h after exposure there was an increase in blood and end-tidal air concentrations of nitrous oxide in seven and nine nurses, respectively. The end-tidal air concentrations of nitrous oxide were greater on Wednesday (22 +/- 7 microgram/l) than on Monday morning (8.4 +/- 1.5 microgram/l), but on Friday they were similar to those measured on Monday morning. The concentrations measured on Sunday, i.e. 2 days after exposure, were similar (average 15 microgram/l) to those measured during the week. It is concluded that, after cessation of exposure to nitrous oxide, there is a rapid decrease in the concentrations in blood and end-tidal air, but small amounts of nitrous oxide remain in the body for at least 3 days after cessation of exposure.

Air Pollutants↗
PubMed1978

Relative potency of some neuromuscular blocking drugs in vivo and in vitro.

The relative potencies of alcuronium, d-tubocurarine, gallamine, pancuronium and succinylcholine as neuromuscular blocking agents were tested in vivo (acute toxicity in mice) and in vitro (rat phrenic nerve-diaphragm preparation). In vivo, pancuronium was about 4 times more potent than alcuronium or d-tubocurarine, whose LD50-values were of the order of 2 X 10(-7) mol/kg. On a molar basis, succinylcholine was about 5 times less potent and gallamine about 20 times less potent than alcuronium or d-tubocurarine. In vitro, succinylcholine was as effective as d-tubocurarine and alcuronium. The IC50-values for these drugs were of the drugs were of the order of 2 X 10(-6)M. Pancuronium was about 2 times less potent and gallamine about 100 times less potent than the other three drugs in vitro. The in vivo-potencies correlate better than those obtained in vitro with observations from the clinical use of these muscle relaxants.

Alcuronium↗
PubMed1977

Recovery, psychomotor skills, and simulated driving after brief inhalational anesthesia with halothane or enflurane combined with nitrous oxide and oxygen.

Recovery from anesthesia was assessed in a controlled manner in 34 healthy student volunteers, using a psychomotor test battery 1 and 5 hours and a driving simulator 2, 4.5, and 7 hours after 3.5 minutes of anesthesia with halothane or enflurane combined with nitrous oxide and oxygen. Psychomotor performances remained significantly (P less than 0.05 to P less than 0.001) worse than in an unanesthetized control group for 5 hours after both halothane and enflurane. However, impairment of driving skills 4.5 hours after anesthesia was measurable only after halothane (P less than 0.05). It is concluded that after even brief periods of halothane or enflurane anesthesia patients should not drive or operate machinery for at least 7 hours. The magnitudes and durations of the residual effects of both agents on psychomotor performance were, however, less than those previously found after thiopental, methohexital, or diazepam.

Adult↗
PubMed1977

The poor reactivity of retinal vessels to systemic administration of vasoactive agents in pentobarbital anesthetized rats.

The responsiveness of retinal vasculature to i.v. administration of several potent vasoactive agents was studied in pentobarbital anesthetized rats by taking fundus photographs. Since cerebral vasculature had been claimed to react in a similar manner but less liably than retinal vessels to some vasoactive substances, the findings were applied to the problem of reactivity of brain vessels. Sublethal doses of noradrenaline, adrenaline, 5-hydroxytryptamine, angiotensin amide and arginine orlysine vasopressin caused no marked acute ( less than or equal to 2 min) vasoconstriction in retinal vessels. Nor did any of these agents or bradykinin elicit vasodilatation. The late vasoconstriction (greater than 2 min) found in succumbing animals was most likely unspecific, since it did not occur until severe toxic symptoms appeared. The findings support the concept that intracerebral vessels are quite resistant to the direct action of many vasoactive agents given i.v.

Animals↗
PubMed1977

Comparison of muscle relaxants in clinical use.

A prospective clinical comparison of d-tubocurarine, alcuronium, gallamine and pancuronium was performed in 400 surgical patients. Various parameters usually followed during clinical anaesthesia were recorded from the beginning of, to the recovery from anaesthesia. Endotracheal intubation was performed with or without suxamethonium. Intubation was always possible in 1-3 min when different muscle relaxants were used in the following initial doses: d-tubocurarine 0.4 mg/kg, alcuronium 0.3 mg/kg, gallamine 1.8 mg/kg, and suxamethonium 0.8 mg/kg. However, there was a statistically significant inferiority of the d-tubocurarine and gallamine groups. The use of suxamethonium seemed to shorten the duration of the initial dose of the nondepolarising agents and also to increase especially the dose of gallamine when calculated as mg/kg/h. It should be mentioned that the non-depolarising agents were given soon after suxamethonium without waiting for the return of spontaneous respiration. Pancuronium and alcuronium caused least changes in the cardiovascular parameters. Erythematous skin reactions were seen mostly after the use of d-tubocurarine and suxamethonium. This could depend on histamine liberating potency of these muscle relaxants.

Adjuvants, Anesthesia↗
PubMed1976

[First aid at medical congresses].

The sixth International Congress of Pharmacology in Helsinki, July 1975, was held on a campus area 5 km from the nearest hospital. The congress was attended by 2 600 active participants and one thousand social members, traveling from 54 countries. The equipment at the Congress first aid station allowed for all kinds of emergency treatments, ranging from the care of minor complaints to cardiopulmonary resuscitation. A mobile intensive care unit was kept outside the station throughout the day and was also available at the major social events in the evening. The great majority of the symptoms necessitating a visit to the station were minor complaints. Most participants received their medication direct from the first aid station, the most common drugs being mild analgesics, anticholinergics and antibiotics. According to our experience, at a congress with 3 500 participants it is sufficient to have one physician present at the first aid station, or at least on call, and one to three additional first aid assistants. In general, it is of utmost importance to make adequate plans for the provision of medical as well as dental care at large congresses.

Congresses as Topic↗
PubMed1975

Recovery and simulated driving after intravenous anesthesia with thiopental, methohexital, propanidid, or alphadione.

Recovery from anesthesia was assessed in a double-bind manner in 40 healthy volunteer students after intravenous anesthesia with thiopental (6.0 mg/kg), methohexital (2.0 mg/kg), propanidid (6.6 mg/kg), or alphadione (Althesin), 85 mul/kg using a driving simulator 2,4, 6, and 8 hours after injection of the drugs. Clinical recovery was faster after propanidid and methohexital than after thiopental or alphadione. Driving performances remained significantly (P less than 0.05) worse than in a control group for 6 hours after thiopental and for 8 hours after methohexital, and reaction times 8 hours after thiopental remained worse than in the control subjects. After alphadione driving skills were impaired at 6 hours only. Propanidid produced no impairment in driving skills at any time during the experiment. It is concluded that after the doses used in this study patients should not drive or operate machinery for at least 2 hours after propanidid and for at least 8 hours after alphadione. After methohexital and thiopental patients should probably not drive for 24 hours because of the severity of the disturbances at 8 hours.

Adult↗