Biomedical subjects
T L Whitsett
Publications and source records attributed to T L Whitsett.
Medical management of shock--drugs of choice and their action.
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Withdrawal of antihypertensive therapy.
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Nitroprusside reversal of ergotamine-induced ischemia.
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Abrupt cessation of clonidine administration: a prospective study.
In 20 patients with mild to moderate hypertension, the effects of abrupt cessation of clonidine therapy on blood pressure, heart rate and catecholamine excretion were evaluated. In a double blind, crossover study, placebo was substituted for clonidine after 3 days of therapy and again after 30 days. The results demonstrated no instances of clinically significant symptoms or overshoot in blood pressure or heart rate. There was an overshoot in norepinephrine excretion that approached the upper limits of normal. Thus, a clinical withdrawal syndrome associated with abrupt cessation of clonidine was not seen in this study of patients without severe hypertension who were given the drug without a diuretic agent.
Reversal of myocardial dysfunction in endotoxin shock with insulin.
Recent data reported from this laboratory have documented myocardial functional depression in endotoxin shock. The purpose of the present study was to determine the effects of insulin on the dysfunctioning canine myocardium subjected to lethal endotoxin shock. Experiments were conducted on isolated working left ventricular preparations in which LD90-100 endotoxin was administered prior to, or following, isolation of the heart. Determinations of myocardial performance were conducted under the conditions of controlled mean aortic pressure and cardiac output. Myocardial dysfunction occurred between 2 and 6 h postendotoxin, as evidenced by significantly increased left ventricular end-diastolic pressure, decreased power, and depressed negative dP/dt, although blood glucose concentrations were maintained at control values. Intraatrial infusions of insulin at rates of 6 U/min reversed all signs of myocardial dysfunction. During insulin infusion, heart rates decreased (p less than 0.02) and myocardial lactate uptake increased (p less than 0.02), while oxygen uptake and coronary blood flow were insignificantly altered.
Cardiac and pulmonary effects of therapy with albuterol and isoproterenol.
This study evaluated the cardiac and pulmonary effects of administering multiple inhaled doses of albuterol, isoproterenol sulfate, and placebo in ten patients with reversible obstructive disease of the airways. The pulmonary effects of therapy with albuterol were similar in magnitude to those of isoproterenol but lasted longer. The inotropic and chronotropic effects of therapy with isoproterenol were greater than those of albuterol. It appears that albuterol has beta2-adrenergic selectivity over a wide range of dosages and is an effective bronchodilator drug.
Albuterol and ephedrine in patients with reversible obstructive airway disease.
This study evaluated the cardiac, pulmonary and neuromuscular effects of albuterol and ephedrine. The pulmonary effects of albuterol occurred earlier, lasted longer and were greater in degree. The cardiac effects of both drugs were virtually non-existent. Tremor was recorded with the higher doses of albuterol.
Letter: Withdrawal of clonidine.
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Sleep patterns and gastric acid secretion in duodenal ucler disease.
Five normal volunteers and five patients with duodenal ulcer (DU) disease were studied for five consecutive nights. All subjects underwent placement of a nasogastric tube, continuous collection of gastric juice, and continuous electroencephalographic monitoring of sleep. Gastric juice was collected in 20-minute samples by remote suction (Gomco). Blood samples were drawn every 20 minutes on the third night via an indwelling venous needle. Results showed no significant correlations between the sleep variables and the gastric acid secretion measures or between the sleep variables and serum gastrin levels. Acid secretion decreased from hour 1 to hour 2 in controls and in patients with inactive DU disease, while it increased in patients with active DU disease. Each subject had at least one night of recording in which continuous gastric secretion was less than 0.1 mEq per 20-minute sample. It appears unlikely that the gastric discomfort of DU patients can be attributed to acid hypersecretion triggered by rapid eye movement sleep.
Panel 1: phase I investigations.
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