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PubMed2003

[Recent findings based on the results of the post-marketing surveillance of vancomycin hydrochloride for intravenous infusion].

Vancomycin Hydrochloride for Intravenous Infusion (VCM) was launched as a therapeutic agent for infections caused by Methicillin-Cephem Resistant Staphylococcus aureus (MRSA) in October 1991. The results of the post-marketing surveillance conducted in accordance with GPMSP for 6 years after the launch are as follows. The population studied included 3,037 patients administered this drug intravenously at 1,099 institutions across Japan from October 1991 through September 1997, and among which, 28 patients were excluded because the follow-up was impossible. Consequently, 3,009 patients were included in the safety evaluation and 2,827 patients in the efficacy evaluation, excluding 182 patients due to the off-label use, etc. The daily dosage of this drug was 40 mg/kg for pediatric patients and 1 or 2 g for adult/elderly patients, and the duration of treatment was commonly 1-3 weeks. The daily dosage and the duration of treatment tended to be decreased over years. The improvement rate by disease was in the 70 to 79% range for respiratory tract infections such as pneumonia, and 80% or more for other diseases such as sepsis and osteomyelitis. With respect to the bacteriological efficacy against MRSA, the eradication rate was 66.9%. The number of cases with adverse drug reactions including clinical laboratory abnormalities was 404 patients (13.43%) and a total of 561 adverse drug reactions were reported. Although there was no trend of particularly high frequency of adverse drug reactions even among elderly patients. Based on the above, VCM is a highly useful drug, which is reliably expected to be effective against MRSA infections, and it seems that VCM should be administered promptly to patients in which MRSA has been identified as a causative pathogen. For the use of VCM, if the optimum dose and mode of administration are selected while taking account of the age and renal function, adverse drug reactions can also be reduced.

Adolescent↗
PubMed1997

Selection of intravenous infusion pumps.

Three broad types of intravenous infusion pump are available--gravity driven, electronic and mechanical devices. The type suitable for a unit will depend on the patient group. Nurses are generally responsible for administering intravenous infusions and should therefore be involved in the purchasing process.

Humans↗
PubMed1987

Continuous intravenous infusion of opioid drugs.

Continuous intravenous infusion of opioid drugs is a widely accepted alternative approach to the management of cancer pain. This review critically evaluates the safety and efficacy of the technique and proffers guidelines for management based on the available literature and clinical experience.

Analgesics, Opioid↗
PubMed1986

Rapid changes in central beta-adrenergic receptors after chronic intravenous infusion of antidepressants.

The effects of intravenous infusion of desipramine (1, 3, 10, and 60 mg/kg/24 hr), amitriptyline, zimelidine, iprindole (3, 10, 30, 60, and 100 mg/kg/24 hr each), imipramine (10, 30, and 100 mg/kg/24 hr), or U-48,753E (1, 3, 10, and 30 mg/kg/24 hr) on the density of central beta-adrenergic receptors were investigated in Sprague-Dawley rats. A comparative study with oral desipramine (3 mg/kg/24 hr) for 74 hrs was also carried out. Desipramine, amitriptyline, zimelidine, iprindole, imipramine, and U-48,753E reduced the density of beta-adrenergic receptors in the cerebral cortex, and the effect seems to be dose-dependent. In the oral study, desipramine failed to down-regulate beta-adrenergic receptors. These results indicate that down-regulation of beta-adrenergic receptors can be rapidly achieved by intravenous infusion of drugs.

Administration, Oral↗
PubMed1981

Intravascular pathobiology of acetyl glyceryl ether phosphorylcholine (AGEPC), a synthetic platelet-activating factor (PAF). I. Intravenous infusion in guinea pigs.

Intravenous infusion of 1-O-alkyl-2-acetyl-sn-glyceryl-3-phosphorylcholine (AGEPC), a synthetic platelet-activating factor (PAF), induced fatal anaphylactoid reaction in guinea pigs, or reversible thrombocytopenia and leucopenia. These reactions showed a maximal depression of circulating platelet and leucocyte numbers within 30 s after AGEPC infusion. Fatal reaction occurred at doses higher than 0.81 micrograms AGEPC/kg, while lower doses of AGEPC caused a reversible thrombocytopenia and leucopenia. The levels of circulating platelets and leucocytes at lower - non-fatal - doses of AGEPC, returned to pre-infusion levels within 60 min. These studies document that intravenous administration of AGEPC, into guinea pigs, initiates identical intravascular infusion of AGEPC into the rabbit and baboon, and supports the notion that the biological activity of AGEPC can cross species barriers.

Anaphylaxis↗
PubMed1989

Salivary excretion of 5-fluorouracil (5-FU). IV. Dependency of saliva/plasma concentration ratio and salivary clearance on plasma concentration of 5-FU during constant-rate intravenous infusion in rats.

Salivary excretion profiles of 5-fluorouracil (5-FU) were investigated following simultaneous bolus intravenous injection of a loading dose and constant-rate intravenous infusion of a maintenance dose of at one of three dose levels in rats. By stimulating salivation with pilocarpine infused intravenously, mandibular (M) and parotid (Pr) saliva samples were periodically collected separately via cannulas inserted into the ducts. Simultaneously, salivary pH and salivary flow rate were determined. (1) There was a good correlation between plasma concentration and each of the saliva concentrations of 5-FU with regard to the pooled data of the three doses (p less than 0.01). (2) A gland type difference between M and Pr in the saliva/plasma concentration ratio (S/P ratio) of 5-FU was observed. This difference seemed to result from that in salivary pH. These findings were similar to the results following bolus intravenous administration of 5-FU in rats. (3) The fluctuations of the S/P ratio and salivary clearance of 5-FU were smaller than those following the bolus intravenous administration. (4) The S/P ratio and salivary clearance were larger at higher dose and higher plasma concentration of 5-FU. It was confirmed that non-linear kinetics might be involved in the salivary excretion of 5-FU in rats, and it was speculated that 5-FU excreted into primary saliva might be reabsorbed partly through some saturable process.

Animals↗
PubMed1979

Protection of gastric mucosa against acute ulceration by intravenous infusion of sodium bicarbonate.

The influence of intravenous infusion of sodium bicarbonate on gastric mucosal injury induced by topical sodium taurocholate and hemorrhagic shock was assessed in a canine ex vivo model. As expected, exposure of the gastric mucosa to sodium taurocholate and acid resulted in excessive back diffusion of hydrogen ions (H+) and mild mucosal damage. This mucosal injury was enhanced by hemorrhagic shock in the control dogs. The degree of mucosal injury was significantly less in the test dogs that received intravenous infusions of sodium bicarbonate. The protection afforded by intravenous bicarbonate was not due to a reduction in the amount of H+ entering the tissue, since the net H+ loss from the lumen was not significantly different between the control and the test dogs. The protection effect of intravenous infusion of sodium bicarbonate is probably secondary to an enhancement of mucosal tolerance to H+. These results support the hypothesis that the enhancement of mucosal injury during hemorrhagic shock may be a result of a decrease in the ability of the gastric mucosa to buffer the influxing H+.

Animals↗
PubMed1990

[Clinical reevaluation of continuous intravenous infusion of 5-fluorouracil--plasma concentrations and clinical dose by continuous intravenous and 60-min infusions].

Daily and intermittent continuous intravenous infusions [by gravity drip, (IVG) or infusion pump, (IVP)] and intermittent short-time intravenous drip infusion of 5-FU were carried out on advanced cancer patients. The MTD and dose-limiting toxicity were investigated in relation to the plasma concentrations of 5-FU determined by HPLC. Responses in eleven patients receiving IVG administration daily at 8-21 mg/kg/day were NC, but those given 5-FU alone showed no adverse reactions. Plasma concentrations were too low to be determined. In 9 patients receiving IVG or IVP administration weekly at 60 mg/kg for 24 hr, 1 of the 5 evaluable patients showed reduced hepatic metastatic lesions. One of 4 patients receiving IVP administration weekly at 120 mg/kg for 48 hr showed a disappearance of metastatic lesions in the skeletal muscle, but bone marrow suppression was observed as dose-limiting toxicity. Pharmacokinetics were more stable in IVP than in IVG with less individual difference in the plasma concentrations. Among the outpatients receiving short-time iv, IVG administration once or twice a week, 2 patients given weekly administrations at 20 mg/kg for 60 min showed slight adverse reactions. In 6 patients given high-dose administrations, bone marrow suppression was observed. When pharmacokinetics in the patients given 5-FU for 60 min were compared between the IVG and IVP groups, there were individual differences in plasma concentrations, but the differences were not significant. It was concluded from above results that the following practical dose schedules would be recommendable: 60 mg/kg for 24hr/week by IVP for inpatients and 20 mg/kg for 60 min/week by IVG for outpatients.

Adult↗
PubMed1993

Intestinal lymphatic pressure increases during intravenous infusions in awake sheep.

Intravenous fluid infusions cause increased venous pressure and increased lymph flow throughout the body. Together the increased lymph flow and increased venous pressure (the outflow pressure to the lymphatic system) should increase the pressure within the postnodal intestinal lymphatics. To test this, we measured the pressure in postnodal intestinal lymphatics and the neck vein pressure in five awake sheep. At baseline, the neck vein pressure was 1.2 +/- 1.5 (SD) cmH2O and the lymphatic pressure was 12.5 +/- 1.7 cmH2O. When we infused Ringer solution intravenously (10% body weight in approximately 50 min), the neck vein pressure increased to 17.3 +/- 0.9 cmH2O and the lymphatic pressure increased to 24.6 +/- 3.8 cmH2O (both P < 0.05). In two additional sheep, the thoracic duct lymph flow rate increased from 0.8 +/- 0.4 ml/min at baseline to 5.5 +/- 2.0 ml/min during the infusions. Our results show that postnodal intestinal lymphatic pressure may increase substantially during intravenous fluid infusions. This is important because increases in postnodal lymphatic pressure may slow lymph flow from the intestine.

Animals↗
PubMed2003

Haemodynamic and pulse wave responses to intravenous infusions of angiotensin II during chronic telmisartan therapy in normal volunteers.

INTRODUCTION: This study investigated the central haemodynamic, blood pressure (BP) and pulse wave responses to progressively increasing infusion rates of intravenous angiotensin II (Ang II) in normal volunteers during chronic therapy with telmisartan or placebo. MATERIALS AND METHODS: Ten normal volunteers, aged 21 33 years, completed a randomised, double-blind crossover study. Ang II was infused intravenously at increasing infusion rates (0 512 ng/minute) at the end of one week of telmisartan therapy (40 80 mg/day) and one week of placebo therapy. BP, central haemodynamics and pulse wave parameters were monitored continuously using a CardioDynamics Recorder, a Pulse Tracer Recorder and a Finipress Recorder. RESULTS: Baseline diastolic BP (57+12 vs. 67+13 mmHg) and pulse wave reflection index (RI) (38.4+18.6 vs. 60.6+12.5%) were significantly lower on telmisartan than on placebo therapy. Cardiac index (CI), systolic BP, systemic vascular resistance index (SVRI), RI and pulse wave stiffness index (SI) were all significantly increased in a dose-dependent manner by Ang II on placebo therapy. Telmisartan significantly (p<0.05) attenuated all of these responses to Ang II. Increases in BP during Ang II infusion were associated with increases in SVRI and CI. CONCLUSIONS: Telmisartan effectively blocked the effects of intravenous Ang II on CI, BP, RI and SI in healthy volunteers. Changes in CI make a major contribution to increase in BP response to intravenous Ang II in normal volunteers.

Adult↗
PubMed1993

Lack of ACTH/cortisol and GH responses to intravenously-infused substance P in Parkinson's disease.

In order to test possible changes in the stimulating effect of intravenously-infused substance P (SP) on ACTH/cortisol and GH secretion in Parkinson's disease, 10 male parkinsonian patients and 10 age-matched normal controls were infused intravenously for 60 min with SP (1.0 or 1.5 pmol/kg-1/min-1 SP) or normal saline. The circulating levels of ACTH, cortisol and GH were measured during and for 20 min after SP or saline infusion. No untoward side effects or changes in blood pressure were observed during SP infusion in any subjects. In basal conditions and during saline infusion, plasma ACTH and cortisol levels were similar in normal and parkinsonian patients. During SP infusions, ACTH/cortisol concentrations in normal controls rose significantly vs baseline and saline test in a dose-dependent fashion. In contrast, at both SP infused amounts, parkinsonian patients showed ACTH/cortisol levels similar to those observed in the saline test. All subjects showed similar basal concentrations of GH. GH levels rose significantly in the normal controls when the higher dose of SP was infused, but they were not modified by the infusion of the lower dose of SP or saline. At both tested amounts of SP and during saline infusion, GH levels remained unchanged in the parkinsonian subjects. In agreement with previous observations in the literature showing SP abnormalities in the parkinsonian brain, these data fail to show significant effects of plasma SP on the ACTH/cortisol and GH secretory systems in Parkinson's disease.

Adrenocorticotropic Hormone↗
PubMed1993

Utilization of intravenously infused maltooligosaccharides in rabbits.

The utilization of intravenously infused maltotriose, maltotetraose and maltopentaose was investigated in rabbits. Rabbits were infused with isotonic solutions of each maltooligosaccharide for 2 h and the utilization was assessed by the 24-h urinary loss of carbohydrates. The utilization of these maltooligosaccharides was good (> or = 87.5%) at a rate of 1 ml/kg/h (< or = 250 mg/kg/h) and poor (< or = 36.2%) at a rate of 5 ml/kg/h (> 250 mg/kg/h). Furthermore, these maltooligosaccharides infused as 5% solution showed good utilization (> or = 86.2%) at a rate of 5 ml/kg/h (250 mg/kg/h). These results suggest the existence of a threshold dose in the utilization of intravenously infused maltooligosaccharides, and this threshold value in rabbits is estimated to be nearly 250 mg/kg/h.

Animals↗
PubMed1986

Response of colo-rectal hepatic metastases to concomitant radiotherapy and intravenous infusion 5 fluorouracil.

Twenty-three patients with colo-rectal hepatic metastases were retrospectively reviewed after completing treatment with split course liver irradiation and continually infused concomitant intravenous 5-fluorouracil. Although no patient attained a complete response, an objective partial response was documented in 15 (Responders). The Responders had a median survival of 45 weeks whereas Non-responders had a median survival of 17 weeks. Patients with metastatic disease solely in the liver or those with a Karnofsky performance score (k.p.s) of over sixty, had a median survival of 49 weeks. Patients with multiple organ metastatic involvement had a median survival of 25 weeks and those with a Karnofsky with less than 60 had a median survival of 27 weeks. (p values of 0.006 and 0.03, respectively.) The overall survival of the group completing treatment was 30 weeks, and 19 patients (83%) achieved subjective palliation. The patients tolerated therapy well. There was minimal hematological toxicity; 3 patients developed a leucocyte count of less than 2000 and 1 developed a platelet count of 30,000. The palliation and prolongation of survival attained with minimal complications suggest that adjuvant liver irradiation with concomitant infusion 5-fluorouracil radiosensitization may be an option to offer patients identified to be at high risk of developing subclinical liver disease.

Adult↗
PubMed1991

[Continuous intravenous infusion of pethidine or buprenorphine for postoperative analgesia].

Efficacy of continuous intravenous infusion for postoperative analgesia was evaluated in 20 patients who had undergone abdominal surgery for 72 hours postoperatively. The patients were randomly allocated to two groups: one group received continuous intravenous infusion of buprenorphine at 0.2 mg.24 hr-1 using a non-electronic, portable infusor 0.5 ml.hr-1 type (Baxter), while the other received infusion of pethidine at 50 mg.hr-1. During the first 12 postoperative hours, the frequency of "Fair" rating which indicated need of supplemental analgetics was significantly higher than the later 12-hour period until 72 hours in both groups. However, although during the first 12 hours continuous intravenous infusion was inadequate to alleviate postoperative pain compared with other 12-hour period, no patient received supplemental analgesics more than 2 times. During the 24 to 72 postoperative hours, 70% of cases needed no supplemental analgesics to alleviate postoperative pain. Continuous intravenous infusion of 0.2 mg.hr-1 buprenorphine or 50 mg.hr-1 pethidine was inadequate for postoperative analgesia during immediately after the operation to 36 hours postoperatively, especially during the first 12-hour period. However, this infusion was effective during 36 to 72 postoperative hours. There was no significant difference between buprenorphine group and pethidine group.

Aged↗