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Biomedical subjects

W S Nimmo

Publications and source records attributed to W S Nimmo.

At least 55 records · Page 3Linked to original sources
PubMed1986

Effect of meptazinol on drug absorption and gastric emptying.

The rate of paracetamol absorption after oral administration was used as an indirect estimate of the rate of gastric emptying in 24 patients before minor surgery. Patients who received 10 mg morphine or 100 mg meptazinol i.m. had significantly delayed absorption as shown by a lower peak concentration and a delayed time to peak. The mean AUC at 90 min was 1,590, 642 and 159 micrograms min ml-1 after saline, morphine and meptazinol respectively. Meptazinol delayed paracetamol absorption more than morphine.

Acetaminophen↗
PubMed1985

Relief of pain by infusion of morphine after operation: does tolerance develop?

To see whether continuous intravenous infusion of opiates provides more effective postoperative relief of pain than conventional intramuscular injection these regimens were compared in a prospective double blind trial. Thirty patients undergoing elective cholecystectomy were allocated randomly to receive an infusion of morphine or an infusion of placebo (control group) for 24 hours. Both groups were allowed supplementary morphine boluses as requested. During the first 48 hours after operation the degree of pain was almost identical between the groups. Surprisingly, the group that was given the infusion of morphine received as much supplementary morphine as the control group during the first 24 hours and appreciably more during the 24 hours after the infusion had been withdrawn. Nausea and vomiting were more prevalent among the patients given the infusion of morphine. These results suggest that continuous infusion of morphine may be an inferior regimen to intermittent bolus administration in the relief of postoperative pain. This may be explained by the development of tolerance in patients who received the infusion of morphine.

Adult↗
PubMed1985

Effect of induction of anaesthesia with etomidate on corticosteroid synthesis in man.

The effects of a single bolus dose of etomidate 0.3 mg kg-1 or thiopentone 5 mg kg-1, on the synthesis of corticosteroid hormones and adrenocorticotrophic hormone (ACTH), were compared for 24 h in 12 patients, undergoing minor surgery under general anaesthesia. Following opioid premedication i.m. and general anaesthesia, plasma cortisol concentrations decreased transiently within the first hour of anaesthesia in all 12 patients. The six patients who received etomidate had statistically higher plasma 11-deoxycorticosterone concentrations at 4 and 24 h than those who had received thiopentone (P less than 0.01). Throughout the study, no difference in plasma cortisol, corticosterone or ACTH concentrations were found between the two groups. We have demonstrated a biochemical effect of a single bolus dose of etomidate consistent with incomplete inhibition of adrenocortical mitochondrial 11 beta-hydroxylase activity, but no clinically significant adrenocortical suppression.

Adrenal Cortex Hormones↗
PubMed1985

Fentanyl by constant rate i.v. infusion for postoperative analgesia.

Fentanyl by continuous i.v. infusion (1.5 microgram kg-1 min-1 or 0.5 microgram kg-1 min-1) was compared with placebo infusion as an analgesic regimen for 24 h after hysterectomy. The drugs were infused using a new disposable device which required no external power source. All patients were allowed morphine i.m. if they experienced pain. Patients in the higher dose fentanyl group demanded less i.m. morphine and had better pain relief after operation, without important respiratory depression.

Female↗
PubMed1985

Aspiration of gastric contents.

Inhalation of gastric contents remains an important cause of anaesthetic death. Recent data describe the acid aspiration syndrome (AAS) as the cause of 25% of maternal deaths associated with anaesthesia and 19% of all deaths totally attributable to anaesthesia (DHSS, 1982; Lunn and Mushin, 1982).

Administration, Oral↗
PubMed1984

Gastric emptying and drug absorption before surgery.

The rate of paracetamol absorption following oral administration has been used as a model of drug absorption and as an indirect estimate of the rate of gastric emptying before and after elective or emergency surgery in 13 adult patients. The rates of paracetamol absorption before and after surgery were not significantly different and compared well with results obtained previously in normal volunteers. This suggests that preoperative anxiety and pain did not delay gastric emptying in this group of patients.

Acetaminophen↗
PubMed1984

Effect of naloxone on gastric emptying during labour.

The rate of gastric emptying was studied in 30 women during labour. All the women had received pethidine 100 mg i.m. for analgesia and, subsequently, extradural analgesia had been established for obstetric indications. The women were allocated randomly to two groups: 15 received naloxone 1.2 mg i.v. and 15 were given saline 3 ml (placebo). All 30 patients were then given paracetamol 1.5 g orally with water 100 ml. The amount of paracetamol absorbed, and hence gastric emptying, was significantly greater in the naloxone group in the first 30 min following the administration of the paracetamol.

Acetaminophen↗
PubMed1984

Drug absorption after general anaesthesia for minor surgery.

Paracetamol absorption after oral administration was studied in eleven patients immediately after a short general anaesthetic for cystoscopy and also in eight healthy volunteers. There were no statistical differences between the rate of paracetamol absorption in the two groups. This suggests that oral medication may be given immediately following a short general anaesthetic when opioid drugs are avoided.

Acetaminophen↗
PubMed1984

Oral ketamine.

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Administration, Oral↗
PubMed1983

Ketamine disposition in children and adults.

The pharmacokinetics of ketamine 2 mg kg-1 i.v. and 6 mg kg-1 i.m. were investigated in nine children undergoing minor surgery. After either route of administration plasma ketamine concentrations were similar to those found in adult patients receiving the same dose, except at later times after i.v. injection, when concentrations were smaller in children. Also, absorption after i.m. injection appeared to be more rapid in children. Substantially larger concentrations of the metabolite norketamine were found in children than in adults after the injection of ketamine. Concentrations of ketamine upon awakening in a further group of nine children receiving ketamine as the sole anaesthetic showed large inter-individual variation. The concentrations were greater than those previously reported for adults. The greater dose requirements in children, compared with adults, are probably attributable to pharmacodynamic rather than pharmacokinetic factors.

Adult↗
PubMed1983

Gastric contents at induction of anaesthesia. Is a 4-hour fast necessary?

The study was undertaken to ascertain whether a light standard breakfast would influence the volume and median pH of gastric contents. Comparisons were obtained between a group of patients (n = 22) fasted overnight and a group (n = 23) allowed a light breakfast. There were no significant differences between the groups in respect of the volume of gastric contents aspirated, the median pH of the gastric contents or the number of patients with a pH of less than 3.0 unit.

Adult↗
PubMed1983

Effect of premedication on drug absorption and gastric emptying.

The rate of paracetamol absorption after oral administration was used as a model of drug absorption and as an indirect measure of the rate of gastric emptying in 37 patients awaiting elective general surgery after different premedications. After saline (control) and diazepam, paracetamol absorption was normal but after morphine or nefopam, absorption was delayed markedly, presumably as a result of delayed gastric emptying. After naloxone there was a small but insignificant delay.

Acetaminophen↗
PubMed1983

Paracetamol absorption from Paramax, Panadol and Solpadeine.

Plasma paracetamol concentrations were measured after oral administration of three pharmaceutical preparations to four healthy volunteers. The formulations were Paramax (paracetamol with metoclopramide), Solpadeine (paracetamol with codeine and caffeine) and Panadol (paracetamol alone). After Solpadeine, concentrations at 15 min were significantly higher than after Panadol. Absorption of paracetamol from Paramax tablets did not differ significantly from Solpadeine or Panadol.

Acetaminophen↗
PubMed1982

Bioavailability, pharmacokinetics, and analgesic activity of ketamine in humans.

The pharmacokinetics of ketamine in analgesic doses after intravenous, intramuscular, and oral administration was investigated in healthy volunteers. Plasma ketamine concentration-time curves were fitted by a two-compartment open model with a terminal half-life of 186 min. Absorption after intramuscular injection was rapid and the bioavailability was 93%. However, only 17% of an oral dose was absorbed because of extensive first-pass metabolism. Simultaneous measurements of the elevation of pain threshold in an ischemic exercise test showed a marked effect for 15-60 min after intramuscular injection, but little or no effect after the oral solution. Pain threshold elevation occurred at plasma ketamine concentrations above 160 ng/ml.

Administration, Oral↗
PubMed1981

Pharmacokinetics and analgesic effect of ketamine in man.

The pharmacokinetics and analgesic effect of i.v. ketamine in doses of 125 microgram kg-1 and 250 microgram kg-1 were determined in five healthy volunteers. Analgesia was measured with the submaximal effort tourniquet test. Both doses of ketamine prolonged the period of pain-free ischaemic exercise while the plasma ketamine concentration was greater than 100 ng ml-1. Ketamine was distributed rapidly (T 1/2 alpha = 17 min). The elimination half-life was 186 min.

Adult↗