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At least 109 records · Page 6Linked to original sources

Approaching long-term neuroleptic treatment of schizophrenia.

Neuroleptic therapy can prevent some acute episodes and may improve the level of function in some cases of chronic schizophrenia. The hazards of tardive dyskinesia require a rigorous design for any long-term use of neuroleptics. The protocol includes narrow indications, demonstrations of efficacy and necessity, and arrangements for surveillance, cooperation, and emergency. Patient instruction improves the precision of medication use and may increase adaptive efforts during episodes.

Antiparkinson Agents↗

[Role of long-acting neuroleptics in the treatment of schizophrenia].

This paper summarizes the presentations made during the Lucca symposium (1-3 October, 1977) on long-acting neuroleptics. The authors tried to present advantages and inconveniences of this therapeutic compared to the "classical" neuroleptic therapeutics: - in patients with an acute symptomatology; - in stabilized patients. The main advantage is that one can be ensured that the drug has been or not been taken.

Acute Disease↗

Plasma gonadotropin response to D-Ala6-LH-RH propylamide.

A long-acting analog of LH-RH, D-Ala6-desGly10-LH-RH propylamide (D-Ala6-LH-RH PA) was administered intramuscularly in a dose of 250 micrograms to 11 women with amenorrhea in whom the determinations of urinary steroid secretion, progesterone challenge, clomiphene, HMG, and LH-RH tests had been performed previously. Blood samples were taken twice before the injection and at 0.5, 1, 2, 4, 8, 12, 24, 26, 28, 30, and 32 h. No visible side effects were observed. Plasma levels of LH and FSH were determined by radioimmunoassays and expressed in mIU/2nd-IRP HMG/ml. The analog caused a great elevation in plasma LH and FSH levels. The maximal absolute increment for LH was between 3.93 and 115.89 mIU/ml, and the maximal increment in percentage was between 220 and 4,300. The time of the LH peak varied between 0.5 and 12 h. For FSH, the maximal absolute increment was between 6.45 and 50.92 mIU/ml and the maximal increment in percentage was between 63 and 1,442. The peak of FSH occurred in most cases at 4 to 8 h.

Adolescent↗

Slow-release metoprolol in angina pectoris. A comparative study of a cardioselective beta-blocking drug, metoprolol, in ordinary and slow-release tablets (Durules) in the treatment of angina pectoris.

A double-blind cross-over study was undertaken to compare the effects of ordinary metoprolol tablets (tablets) 0.1 g b.i.d. and metoprolol slow-release tablets (Durules) 0.2 g once daily in 16 patients with angina pectoris. Initially, the patients were treated with placebo for 2 weeks, and then during the cross-over periods with either 1 tablet morning and evening or 1 Durules in the morning and 1 placebo in the evening. Standardized bicycle ergometer exercise tests with heart rate and blood pressure measurements were performed 2 hours after placebo, 2 hours after tablets and Durules, 12 hours after tablets and 24 hours after Durules. The patients kept diaries of their anginal attacks throughout the study. There were no statistically significant differences in total work between tablets and Durules when the values at 12 hours and 24 hours were compared. However, total work was significantly greater at 2 hours and at 12 hours after tablets and 24 hours after Durules than after placebo. Heart rate and systolic blood pressure during exercise were significantly decreased 24 hours after Durules compared to placebo. The heart rate was, however, lower 12 hours after tablets than 24 hours after Durules (p less than 0.05), although this slight difference in the degree of beta-blockade did not seem to be of clinical importance in these patients.

Administration, Oral↗

Treatment of duodenal ulcer with a long-acting synthetic secretin: a pilot trial.

In three male duodenal ulcer patients, the effects of a 4-week treatment with a long-acting synthetic secretin -- daily s.c. administrations of 10 clinical units secretin/kg b.w. -- were assessed symptomatically, endoscopically, immunologically, and by means of gastric and pancreatic secretory analyses. Improvement in epigastric pain was noted within a few days following the onset of secretin therapy. In all cases, duodenoscopy revealed complete healing of ulcers after a 2- to 3-week treatment period. Before therapy, cutaneous anaphylactoid reactions due to intradermal injections of secretin could be elicited in each subject; skin reactions were found mitigated after 4 weeks of therapeutic secretin administration thus suggesting some desensitisation. Neither gastric acid secretion nor pancreatic bicarbonate production were substantially influenced by the 4-week course of secretin therapy; consequently, prevention of ulcer relapse is rather unlikely to be achievable with the conditions employed in this study. However, it seems therapeutically promising that the duodenal ulcers under study showed complete healing already after 2-3 weeks of secretin administration.

Adult↗

Quinidine syncope: torsade de pointes with low quinidine plasma concentrations.

In 2 patients without clinically significant ischemic heart diseases, oral quinidine was used to control supraventricular arrhythmias. In both patients, syncopal attacks occurred, caused by a particular type of ventricular tachyarrhythmia called torsades de pointes. Quinidine plasma concentrations were low (2.6 and 1.2 mg/1, respectively); QRS duration was normal, but the Q-T interval was markedly prolonged.

Aged↗

[Zollinger-Ellison syndrome treated medically by an inhibitor of H2 histamine receptors].

Metiamide an histamine H2-receptors antagonist has been used to treat a case of Zollinger-Ellison syndrome characterized by a long standing diarrhea, an important gastric hypersecretion and a moderatly elevated plasma gastrin but without digestive ulceration. At the dose of 600 mg per day, Metiamide induced a complete suppression of acid secretion, an effect which lasted for 15 days after stopping the drug. Accordingly and since the only finding at time of laparotomy was a small lymph node enlarged with endocrine metastatic tissue, the stomach was left intact and Metiamide pursued. During the first 4 months of chronic administration of Metiamide, acid secretion was maintained at levels below 25 p.cent of initial values. Ulteriorly however, although dosages of Metiamide were increased, acid hypersecretion resumed and a duodenal ulcer developed. Total gastrectomy was then performed 11 months after the beginning of Metiamide. In spite of the failure of Metiamide treatment, the long term follow up of this case of Zollinger-Ellison Syndrome, allowed us to get theoretical and practical informations.

Adult↗

[Drug-drug interactions (author's transl)].

This short outline of drug-drug interactions does not claim to cover the entire field. The task of this paper is to illustrate the most important principles of drug-drug interactions by paradigms taken from the experience of the practitioner. One consequence of drug-drug interactions is the change in pharmacolinetic parameters important for the therapeutical effect of drugs in the organism. Very often the elucidation of the mechanisms of drug-drug interactions in man is impossible; therefore, for clinical pharmacologists experiments on animals remain the tool in order to gain more knowledge in this field.

Age Factors↗

[Galenical possibilities and problems in protraction of drug effects (author's transl)].

In recent years, dosage forms with sustained release have obtained a significant importance. The technological possibilities for manufacturing are described as coating, embedding and matrix procedures. The range of auxiliary substances, which are responsible for the retardation of drug activity, reaches from lipophilic compounds as lipoids, fatty alcohols and compounds which are forming hydrogels as cellulose derivatives and natural polysaccharides to synthetic polymers derived from acrylic acid. The formulation of the dosage forms requires particular care in respect to the amount of initial and maintenance doses. On account of technological processes, for example during manufacturing of tablets, under certain circumstances the liberation rate is altered. In vitro test methods allow comparisons only then when the results can be counter-checked by in vitro experiments. The release of drug follows different mechanisms, which are described, entirely or in part, to be reactions following the time law of zero or first order. In special cases, a linear correlation is observed as a function of square root of time. The calculation of given special equations for events within the dosage form is feasible from blood-level values.

Biological Availability↗