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  • 1
    ISSN: 1432-0584
    Keywords: Androgene ; Myeloproliferative Störungen ; Anämie ; Thrombopenie ; Androgens ; Myeloproliferative disorder ; Anemia ; Thrombocytopenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In order to study the effect of oxymetholone therapy in advanced myelofibrosis, 11 patients (4 females, 7 males) were given, 3–5 mg per kg body weight, long-term oxymetholone treatment in a prospective multicenter study. Five cases had previously had a diagnosis of polycythemia vera. All patients had anemia initially, 4 leukocytopenia and 10 thrombocytopenia in addition. Hepato-splenomegaly was present in all cases but in varying degree. Five patients required regular blood transfusions before treatment. In 9 of the 15 courses given, there was normalization of the peripheral blood or substantial improvement (better than 3 g hemoglobin/dl or 50×109 platelets/1) after androgens. Significant effects were noted both on hemoglobin values and platelet counts. The need for blood transfusions ceased completely in all 5 cases. When oxymetholone treatment was reduced or interrupted 4 patients relapsed; 2 of them responded to a renewed course. The red cell counts returned to previous polycythemic values in one patient and another died from acute leukemia. The results of this study suggest that androgens might be of value in advanced cases of myelofibrosis with transfusion-requiring anemia or severe thrombocytopenia.
    Notes: Zusammenfassung Die therapeutische Wirksamkeit von Oxymetholon bei fortgeschrittener Osteomyeloflbrose wurde im Rahmen einer prospektiven Studie geprüft. 11 Patienten (4 Frauen, 7 Männer) erhielten 3–5 mg/kg Körpergewicht Oxymetholon. 5 dieser Patienten hatten vorher eine polyzythämische Phase. Alle Patienten hatten bei Beginn des Therapieversuchs eine Anämie, 4 eine Leukopenie und 10 zusätzlich eine Thrombopenie. Eine Hepatosplenomegalie war immer vorhanden. 5 Patienten benötigten vor Behandlung regelmäßig Bluttransfusionen. In 9 von 15 Therapiephasen wurde eine Normalisierung und deutliche Besserung beobachtet. Die Veränderungen des Hämoglobinspiegels und der Plättchenzahl waren signifikant. 4 Patienten verschlechterten sich nach Dosisreduktion oder bei Absetzen von Oxymetholon; 2 davon sprachen erneut an. Bei einem Patienten kehrten die Werte zu den früher bestehenden polyzythämischen Werten zurück. 1 Patient starb durch eine akute Leukämie. Die Ergebnisse der Studie weisen daraufhin, daß Androgene in weit fortgeschrittenen Fällen von Myelofibrose mit transfusionsbedürftiger Anämie oder schwerer Zytopenie von Wert sein könnte.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 26 (1984), S. 347-355 
    ISSN: 1432-1041
    Keywords: cimetidine ; cirrhosis ; pharmacokinetics ; bioavailability ; clearance reduction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of impaired liver function on the pharmacokinetics of cimetidine was studied in 8 patients with advanced cirrhosis given single doses of 100 mg i.v. and 400 mg p.o. on separate days. Compared to a control group of 10 healthy volunteers, the total renal and nonrenal clearance was significantly reduced in the cirrhotic patients; (total plasma clearance mean ± SD) 356±181 vs 789±262 ml/min (p〈0.01); renal clearance (Clr) 296±100 vs 588±181 ml/min (p〈0.01) and nonrenal clearance (Clnr) 97±111 vs 205±89 ml/min (p〈0.05). Compared to published results for age-matched ulcer patients, both total and nonrenal clearance were lower whereas renal clearance was within the reported normal range. A significant reduction in volume of distribution (Vdβ) was found, from 2.1±0.1 l/kg in controls to 1.0±0.4l/kg, and in the patient group there was a significant correlation between Vdβ and total plasma clearance (r=0.72, p〈0.05). Volume of distribution in steady state (Vdss) did not differ from published results in age-matched controls. No significant change in half-life was found. Bioavailability, estimated by AUC-measurement, showed considerable patient variability (21–143%), with a mean of 70±39%. This was lower than in the controls. In contrast, measurement of urinary excretion showed higher bioavailability in the patients (66±23 vs 51±8%). No correlation was found between any of the kinetic parameters and the clinical and laboratory data. It is suggested that patients with advanced cirrhosis should be closely observed when given cimetidine, and a reduction in dose should be concidered if side effects are to be avoided.
    Type of Medium: Electronic Resource
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