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Biomedical subjects

W Zilly

Publications and source records attributed to W Zilly.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Effect of a fiber-rich diet on digoxin resorption].

In five female healthy volunteers the influence of dietary fiber (wheat bran or carob seed flour) on absorption of digoxin was investigated. Five minutes after ingestion of a formula diet alone or in combination with wheat bran or carob seed flour 0,8 mg beta-acetyldigoxin was given per os. The plasmaconcentration-time curve over eight hours, the area under curve and the cumulative urinary excretion were not changed significantly. It was concluded that there is no influence of dietary fiber on rate or degree of digoxin-absorption.

Acetyldigoxins↗
PubMed1981

Effects of cytostatic drugs on plasma level and renal excretion of beta-acetyldigoxin.

Mucosal defects decrease digoxin absorption in patients with malabsorption syndromes. Since the intestinal mucosa can be damaged by cytostatic drugs, we investigated their effects on digoxin plasma levels and urinary digoxin excretion. In six patients with malignant lymphoma who received 0.8 mg beta-acetyldigoxin before and 24 hr after treatment with a combination of cyclophosphamide, oncovin, procarbazine, and prednisone (COPP) or cyclophosphamide, oncovin, and prednisone (COP), plasma digoxin concentrations were measured 0 to 8 hr after the dose and areas under the plasma concentration-time curves were calculated. In 15 patients on 0.3 mg of beta-acetyldigoxin daily, plasma glycoside concentrations and renal excretion were measured daily before and after COPP, COP, cyclophosphamide, oncovin, cytosine-arabinosine, and prednisone (COAP), or adriamycin, bleomycin, and prednisone (ABP) treatment schemes. The diminished steady-state glycoside plasma concentrations and daily renal glycoside excretion during the 24 to 168 hr after the cytostatic drug established reversible impairment of digoxin absorption. The delayed time to peak after a single dose of digoxin during cytostatic drug therapy shows that extent and rate of digoxin absorption are reduced. To maintain adequate control of digoxin therapy in patients treated with cytostatic drugs, plasma levels should be monitored.

Acetyldigoxins↗
PubMed1980

Disposition of hexobarbital in intra- and extrahepatic cholestasis in man and the influence of drug metabolism-inducing agents.

The pharmacokinetics of intravenously infused hexobarbital was studied in 10 patients with intrahepatic cholestasis and in 9 with extrahepatic biliary obstruction. The results were compared with those obtained in 16 healthy young volunteers and 5 older patients with normal liver function. After infusion, the plasma concentrations showed a rapid initial decline (alpha-phase) and subsequently a slower decrease (beta-phase). The half-life of a latter phase was 323 +/- 84 min in the healthy group, 357 +/- 151 min in the patients with intrahepatic cholestasis and 344 +/- 115 min in the group with biliary obstruction; the clearances were 3.41 +/- 0.90, 4.08 +/- 1.95 and 3.81 +/- 1.97 ml x min-1 x kg-1, respectively. The differences were not statistically significant. The mean volume of the central compartment of distribution and the steady state volume of distribution were not significantly different. In two patients hexobarbital clearance during cholestasis was greater than after it had subsided. After treatment of 11 patients with cholestasis with drug metabolism-inducing agents (phenobarbital, rifampicin or phenytoin), the half-life of hexobarbital was significantly shortened and the mean value of hexobarbital clearance was more than doubled.

Adult↗
PubMed1980

Chiba-needle percutaneous cholangiography - a method without risk to the patient?

This critical review of PTC with the skinny needle was prompted by an unexpected complication - an intrahepatic hematoma. A negative PTC does not exclude the presence of dilated bile ducts. In the case of an obstructed biliary tree, bile leakage occurs in approximately 5%. Even after the Chiba needle or other techniques have become established, peritoneoscopy is still of value in the diagnosis of cholestasis. Thus, this method is not without some risk and optimistic reports should be judged with a certain reserve.

Aged↗
PubMed1980

Pharmacokinetics and metabolism of theophylline in patients with liver diseases.

In patients with acute hepatitis, cholestasis, and compensated or decompensated liver cirrhosis the kinetics and urinary excretion of theophylline and metabolites were investigated following intravenous administration (193 mg). Significant decreases of plasma clearance and a prolongation of the plasma elimination half-life were found only in cases with decompensated liver cirrhosis and to a lesser extent in cases of acute hepatitis. The metabolite pattern in urine was changed in all disease groups compared to controls, i.e., increased excretion of 1-methyl uric acid and a concomitant decrease of 1,3-dimethyl uric acid and particularly of 3-methylxanthine. These results allow the following conclusions. In liver disease the 1-demethylation of theophylline is inhibited; this inhibition appears to be compensated by a shift towards 1-methyl uric acid formation. The monitoring of plasma levels of theophylline is indicated, especially in therapy of patients wtih decompensated liver cirrhosis.

Cholestasis↗
PubMed1980

[Drug metabolism in patients with liver disease (author's transl)].

Patients with acute hepatitis and patients with compensated or decompensated cirrhosis of the liver have a decreased plasma clearance of hexobarbital. This however could not been demonstrated in patients with intra- or extrahepatic cholestasis and patients with primary biliary cirrhosis of the liver. The plasma clearance of methohexital, - a high clearance drug - is not changed in the same way. Also there is no evidence as yet, that patients with liver disease and without a collateral portal circulation do have an increased bioavailability of oral high clearance drugs.

Acute Disease↗
PubMed1979

[Methohexital clearance in patients with acute hepatitis (author's transl)].

Pharmacokinetics of methohexital were studied in patients with acute hepatitis and after a treatment period either with "essential phospholipids" or phenobarbital. During the acute phase the distribution of methohexital was significantly altered. No change had been observed in the methohexital clearance. During remission the distribution of methohexital was in a normal range. After treatment with phenobarbital the methohexital clearance increased significantly whereas no change was observed after treatment with "essential phospholipids".

Acute Disease↗
PubMed1979

The effect of dietary fiber on postprandial serum digoxin concentration in man.

The postprandial digoxin concentrations in serum were measured for 4 hr by radioimmunological assay in six healthy volunteers who had received 0.8 mg beta-acetyldigoxin by the oral route. Digoxin was given together with a formula diet containing as admixture, respectively, wheat bran, microcrystalline cellulose, pectin, carrageenan, and carob seed flour. The various additions did not reduce the mean digoxin concentrations in serum. After carob seed flour, the concentrations were significantly (P less than 5%) higher, as compared to the control. After microcrystalline cellulose, pectin, and wheat bran the mean peak concentrations were reached later than in the control state.

Acetyldigoxins↗
PubMed1979

[Fiberendoscopic injection therapy of bleeding gastrointestinal lesions (author's transl)].

In 28 patients with acute gastrointestinal bleeding emergency fiberendoscopy was combined with aethoxysclerole (1%) injection of the bleeding lesion with purpose to controll haemorrhage. In 61% of 31 proceudres done in patients with oesophageal varices (n = 19) haemorrhage was controlled, and in further 16% deminuation of bleeding intensity was noted. In the remaining cases (n = 7) the procedure was ineffective. Only patients with Child C liver cirrhosis having oesophageal varices stages III and IV finally died because of uncontrolled haemorrhage. In 9 patients with bleeding from other lesions (gastric erosions and ulcers, Mallory-Weiss-Syndrome, erosio simplex Dieulafoy) haemorrhage was controlled in 8 patients. The method is practicable and efficient, but does not determine better the final outcome of patients with livercirrhosis Child C having oesophageal varices stages III and IV. In other cases tube treatment was avoided. The operation lethality within the series was 1,5%.

Endoscopy↗
PubMed1979

[Percutaneous transhepatic--versus endoscopic retrograde cholangiography in the differential diagnosis of cholestasis? (author's transl)].

Since the introduction of the Chiba needle the percutaneous transhepatic cholangiography (PTC) became an established method in the differential diagnosis of cholestasis beside the endoscopic retrograde cholangiography (ERC). From the clinical point of view it is sometimes difficult to decide which of these two techniques should be preferred. In case of absolute or relative contraindications or in case of failure of one of the two methods ERC and PTC can be used alternatively. In all other cases we feel that the PTC by means of the Chiba needle is superior because of easier technical handling and higher success rate. In addition PTC is less trying for the patients. However on the basis of our own experience is should be stressed, that even by using skinny needles there is danger of bile leakage, which necessitates an immediate surgical intervention in the presence of biliary obstruction.

Cholangiography↗
PubMed1979

[Studies on drug metabolism in obese men and mice (author's transl)].

In 7 obese patients with an overweight of 53 +/- 19% of Broca we found a 2-fold enlarged apparent volume of distribution and a nearly 2-fold prolonged elimination halflife of hexobarbital; the hexobarbital plasma clearance however, which is nearly identical with the metabolizing capacity of the liver for hexobarbital, was not decreased. Phenobarbital induced the microsomal drugmetabolizing enzyme system in the fatty liver of genetically obese mice in the same way 2-3-fold as in the non-fatty liver of the lean littermates.

Adolescent↗
PubMed1979

Alternative transport pathways of cholephilic 14C-hexobarbital metabolites in rats with experimental hepatitis and cholestasis.

Object of the investigation was to find out whether otherwise cholephilic metabolites are excreted via an alternative pathway into urine in experimental liver disease. Intraduodenal application of 14C-labelled hexobarbital in rats is followed by an immediate biliary excretion of metabolites in the range of 400 microgram/100 g bw/h. Using TLC these metabolites can be separated into a polar fraction (about 80% of total) and a non-polar fraction. Phenobarbital treatment leads to a decrease of the total biliary excretion of metabolites to about 200 microgram/100 g bw/h, the metabolite pattern remaining unchanged. Animals with a mild form of GalN-hepatitis had a moderate reduction of bile flow and a total metabolite output of 40 microgram/100/gbw/h. The metabolite pattern showed a decrease mainly of the polar fraction. In animals with an early stage of ANIT cholestasis a 50% reduction of bile flow was associated with a total metabolite excretion of only 20 microgram/100 g bw/h and polar metabolites were nearly absent. In both types of experimental liver disease in corresponding urine samples otherwise cholephilic metabolites appeared. The results obtained show that clinically moderate stages of experimental liver disease lead to a significantly diminished output especially of polar 14C-hexobarbital-metabolites into the bile, which can, therefore, appear in the urine instead.

1-Naphthylisothiocyanate↗
PubMed1978

[Bioavailability of Ce-Ferro forte. Comparative iron load test (author's transl)].

The intraindividual relative bioavailability of three oral iron preparations was investigated in 9 male and 3 female healthy volunteers. After an overnight fast each of the volunteers took 110 mg Fe++ in a weak gelatine capsule soluble within the duodenum (Ce-Ferro forte) or 105 mg and 100 mg Fe++ respectively in commercial preparations. Care was taken that a 3 days interval took place between the investigations. Before taking and 1/2, 1, 2, 4, 6, 8 and 12 hrs. after taking the iron capsule, blood was withdrawn into heparinized test tubes and plasma iron concentrations were determined using an atomic absorption spectrophotometer. After taking Fe++ sulfate in a weak gelatine capsule (A), the mean plasma iron increased significantly higher in comparison to preparation B in the 2nd and in the 4th hour and in comparison to preparation C in the 1st hour. The area under curve of iron increase was 531 +/- 329 (SD) after A, 415 +/- 327 And 414 +/- 390 after B and C respectively without significant changes. From these data was concluded that Fe++ sulfate in a duodenal soluble weak gelatine capsule has a beter bioavailability than the 2 other preparations investigated.

Administration, Oral↗
PubMed1978

[Pharmacokinetics of digoxin and methyldigoxin in patients with acute hepatitis (author's transl)].

After i.v. application of 3h-digoxin or 3H-methyldigoxin to 5 healthy volunteers and 5 patients with acute hepatitis, respectively (0.75 mg daily for 3 days and 0.375 for the following 2 days) total radioactivity in urine and plasma were determined. Chloroform-soluble and -insoluble glycosides were separated and the chloroform-soluble fraction was determined by TLC. 3 days after methyldigoxin application plasma levels reached toxic values in the patient group (2.73 +/- 0.48 ng/ml), whereas in patients receiving digoxin a mean plasma level of 0.91 +/- 0.21 ng/ml was obtained. During the first 24 hours following administration of digoxin 44 +/- 12% of the dose were recovered in urine of control subjects and 48 +/- 13% in patients with acute hepatitis, after methyldigoxin 34 +/- 5% and 34 +/- 8%, respectively. Metabolism of digoxin in patients with acute hepatitis was unaltered, whereas a diminished demethylation rate of methyldigoxin could be observed. 16 patients with acute hepatitis and 7 healthy volunteers received unlabelled digoxin p.o. as maintenance dose. Plasma glycoside concentrations were studied by radioimmunoassay. The average glycoside plasma concentrations were 0.59 +/- 0.21 ng/ml and 0.63 +/- 0.24 ng/ml, respectively.

Animals↗