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  • 1
    Electronic Resource
    Electronic Resource
    Drug disposition in patients with HBsAg-positive chronic liver disease (1987)
    Springer
    Digestive diseases and sciences 32 (1987), S. 710-714 
    Details
    ISSN: 1573-2568
    Keywords: chronic hepatitis ; drug clearance ; pharmacokinetics ; antipyrine ; lidocaine ; aminopyrine breath test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chronic infection with hepatitis B virus (HBV) results in a spectrum of hepatic abnormalities ranging from minimal liver dysfunction to severe liver failure. These patients provide an opportunity to examine the relationship between the evolution of the liver disease and the ability to metabolize drugs. We have examined hepatic drug disposition in patients with chronic persistent hepatitis, chronic active hepatitis, and cirrhosis due to HBV infection. Four model drugs were used: two low-extraction capacity-limited drugs (antipyrine and aminopyrine) and two high-extraction flow-limited drugs (ICG and lidocaine). The disposition of the four drugs tested was comparable to that of healthy controls in patients with chronic persistent hepatitis, chronic active hepatitis, and mild cirrhosis. In patients with severe cirrhosis (as defined by the presence of ascites, encephalopathy, or large esophageal varices), there was a significant impairment in the aminopyrine breath test (−31%) and in the clearance of antipyrine (−53%), lidocaine (−49%), and ICG (−54%). These results indicate that impairment of drug clearance occurs only late in the evolution of HBV-related chronic liver disease. This is in keeping with the known slow and insidious progression of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01296136
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Methyltert-butyl ether in the endoscopic treatment of common bile duct radiolucent stones in elderly patients with nasobiliary tube (1992)
    Springer
    Digestive diseases and sciences 37 (1992), S. 97-100 
    Details
    ISSN: 1573-2568
    Keywords: common bile duct stones ; endoscopic extraction ; methyltert-butyl ether ; stone dissolution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Methyltert-butyl ether is an effective dissolution agent for cholesterol stones. The aim of this work was to evaluate the effect of methyltert-butyl ether on radiolucent common bile duct stones in patients in whom endoscopic extraction has failed. From September 1985 to September 1987, 1374 patients underwent endoscopic retrograde cholangiopancreatography in our Liver Unit. An endoscopic sphincterotomy was indicated in 195 patients with common bile duct (CBD) stones because of an age over 65 years and/or surgical contraindications. Endoscopic sphincterotomy was efficient in 187 patients, allowing complete stone removal in association with conventional endoscopic methods and mechanical lithotripsy in 170 patients. Twelve of the 17 patients with failure of conventional endoscopic treatments were either older than 75 years (11 patients; mean age, 86±4.5 years) or exhibited a surgical contraindication. Stones completely obstructed CBD in six patients and had a diameter exceeding 25 mm in the six other patients. These subjects were selected for stone dissolution by methyltert-butyl either (MTBE) according to the following protocol. MTBE was directly infused into CBD through a nasobiliary catheter, twice daily for 4–13 days (mean, seven days). Bile duct opacification, repeated after MTBE treatment, revealed the complete disappearance of CBD stones in one patient, a decrease in stone size in five patients and no change in the six tther patients. MTBE treatment was well tolerated except in three patients who complained from transient abdominal pains and nausea. At the second attempt of endoscopic treatment, CBD stones were found to be softened and easily broken up, allowing a complete clearance in six patients. MTBE treatment failed to improve stone extraction in the five other patients. These results show that, in patients with large radiolucent stones in the CBD, unextractable by conventional endoscopic methods, the direct infusion of MTBE in CBD rarely led to a complete stone dissolution; however, this treatment partially solubilizes stones, enabling their complete endoscopic extraction thereafter in half the patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01308349
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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