PubMed Health⌕ Search

Biomedical subjects

R Karlstadt

Publications and source records attributed to R Karlstadt.

9 recordsLinked to original sources
PubMed1994

Famotidine increases plasma alcohol concentration in healthy subjects.

The effect of famotidine on plasma alcohol concentration was studied in 24 healthy male subjects who demonstrated high apparent ethanol first-pass metabolism after oral (p.o.) and intravenous (i.v.) ethanol administration (i.e. AUC(po) < or = 40% of AUC(i.v.), where AUC is area under the plasma ethanol concentration-time curve). Six of the original 30 subjects screened (20%) did not demonstrate high first-pass metabolism and were excluded. In a randomized open crossover study, oral ethanol pharmacokinetics were assessed after breakfast in the morning following a 3-day regimen of famotidine, 40 mg/day, and following a no-drug control period. Famotidine increased the area under the plasma ethanol concentration-time curve (AUC0-t) by 29% (7.1 vs 5.5 mg.h/dL, P = 0.006) and maximal plasma concentration (Cmax) by 23% (9.2 vs 7.5 mg/dL, P = 0.013). The changes in ethanol AUC0-t and Cmax may have been associated with changes in gastric emptying, as they were inversely correlated with changes in the time at which maximal plasma concentration was attained. There was considerable intra-individual variation in ethanol AUC and Cmax. As a result, regression to the mean is a potentially confounding problem in ethanol pharmacokinetic studies when subjects are selected on the basis of having low AUC(po), and properly controlled randomized studies of substantial size are required to detect modest drug effects. Small effects on ethanol pharmacokinetics have now been demonstrated with all four of the major H2-receptor antagonists, but these effects are seen only under specific experimental conditions and appear to be unimportant clinically.

Administration, Oral↗
PubMed1990

Maintenance therapy of duodenal ulcer with H2-receptor antagonists--a meta-analysis.

A theoretical basis for similar recurrence rates among H2-receptor antagonists exists based on recent concepts of ulcer recurrence, ulcer healing and suppression of nocturnal gastric acidity. In order to compare H2-receptor antagonists in the maintenance therapy of duodenal ulcer, a meta-analysis was carried out using 29 studies in the literature that met strict criteria. When the results of the placebo-controlled studies were expressed as odds ratios, a technique used to minimize differences in protocol design and patient populations among studies, cimetidine, ranitidine, famotidine and nizatidine were all found to be superior to placebo to approximately the same extent. Odds ratios (and 95% confidence limits) for the recurrences in the pooled studies were cimetidine 0.22 (0.18-0.28), ranitidine 0.23 (0.18-0.30), famotidine 0.28-0.31 and nizatidine 0.36. These reflected similar 1-year recurrence rates of 24.9% (n = 530) for 400 mg cimetidine nocte, 22.4 (n = 508) for 150 mg ranitidine nocte, 28.0% (n = 371) for 20 mg or 40 mg famotidine nocte, and 21.8% (n = 261) for 150 mg nizatidine nocte. In studies to compare cimetidine and ranitidine directly, the odds ratio (and 95% confidence limits) was 0.64 (0.48-0.86). However, for two studies done by a single protocol, the odds ratio of 0.51 (0.35-0.75) tended to differ from the odds ratio of 0.85 (0.54-1.33) for six other studies (P = 0.09). These reflected recurrence rates for cimetidine and ranitidine of 28.3% and 16.8% (two studies) and 23.3% and 20.6% (six studies) respectively.

Cimetidine↗
PubMed1989

Comparison between continuous and intermittent infusion regimens of cimetidine in ulcer patients.

The relative effectiveness of intermittent infusions and primed continuous infusions of cimetidine in the maintenance of intragastric pH greater than or equal to 4.0 was evaluated in a double-blind crossover trial in 26 patients who had active or healed gastroduodenal ulcers. During the intermittent phase, each patient received 300 mg cimetidine intravenously every 6 hours. During the continuous infusion phase, each patient was given a continuous infusion of 37.5 mg cimetidine per hour, preceded by a priming dose of 300 mg cimetidine that was given for 15 minutes. Intragastric pH was monitored continuously. During the last 12 hours of the study, the continuous infusion regimen provided 20% more time in which the pH was more [corrected] than 4.0 with 25% less medication than did the intermittent infusion regimen.

Adolescent↗
PubMed1989

Acute treatment of benign gastric ulcer with once-daily bedtime dosing of cimetidine compared with placebo.

This multicentre, double-blind study evaluated the efficacy of cimetidine 800 mg nocte compared to placebo for ulcer healing and pain relief in patients with endoscopically confirmed, benign gastric ulcers treated for up to 8 weeks. Cimetidine accelerated ulcer healing throughout the study. More cimetidine-treated patients (35 of 82, 43%) than placebo-treated patients (26 of 79, 33%) had healed ulcers after 4 weeks of therapy. Similarly, after 6 and 8 weeks of treatment, cimetidine continued to have superior healing rates, 76% (59 of 78, P = 0.02) and 91% (69 of 76, P = 0.02) heal rates for cimetidine recipients compared with 58% (42 of 73) and 74% (52 of 70) for placebo. For every week of the study except the second, a greater proportion of cimetidine-treated patients were free of daytime and night-time pain than placebo-treated patients; the differences were statistically significant for night-time pain. Adverse reaction profiles were similar for the cimetidine and placebo groups. In conclusion, cimetidine 800 mg nocte was comparably safe and significantly more effective than placebo in accelerating healing and relieving pain in the treatment of acute, benign gastric ulcer.

Adult↗
PubMedDate not supplied

Once-daily bedtime dosing regimen of cimetidine in the treatment of gastric ulcer.

In a double-blind study of 163 patients with benign chronic gastric ulcer, 83 were randomly assigned to receive 800 mg of cimetidine once daily at bedtime for six weeks and 80 received placebo. After six weeks of treatment, the ulcers were healed in 76% of the cimetidine-treated patients and in 55% of the placebo group (P less than 0.003). Within two weeks of starting cimetidine treatment, over 60% of the patients were without daytime or nighttime pain. At six weeks. 77% of the cimetidine-treated patients and 67% of the placebo group were without daytime pain and 89% and 74% (P less than 0.05), respectively, were without nighttime pain. The proportion of pain-free nights and days increased each week in the cimetidine-treated patients. Transient and self-limited adverse experiences were reported by 13% of the cimetidine-treated patients and by 15% of the placebo group. The results achieved in the present study with a once-daily, bedtime dose of cimetidine are similar to those seen in patients given cimetidine twice and four times daily.

Adolescent↗