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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 37 (1989), S. 533-536 
    ISSN: 1432-1041
    Keywords: bismuth ; absorption ; elimination ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of bismuth subcitrate were studied in plasma and urine under conditions of single and multiple dosing (28–56 days) using atomic absorption technique. Single dose plasma pharmacokinetics showed peak concentrations of 5.5–57.5 µg·l−1 (mean=24.7 µg·l−1), reached between 30 and 60 min post dosing with an apparent biphasic elimination pattern. Multiple dose studies showed a continuing rise in plasma concentration and urine excretion rate reaching apparent steady-state levels over 7–29 days (mean=18 days). Washout studies in 6 individuals reciprocated accumulation. Maximum equilibrated plasma levels of 7.6–58.3 µg·l−1 (mean=38.3 µg·l−1) were well below those associated with encephalopathy. The half-life of bismuth elimination was 20.7 days. Present patterns of intermittent dosing with bismuth are unlikely to be associated with bismuth accumulation despite slow accumulation and elimination.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: Key words Transdermal ; Nicotine ; Plasma concen-trations ; Cotinine ; Smoking cessation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Interindividual variability in plasma concentrations of nicotine and its proximate metabolite, cotinine, is considerable during smoking and transdermal nicotine treatment, even among individuals taking in nominally similar doses of nicotine. This report explores the determinants of this variability and the utility of baseline (smoking) plasma concentrations to predict concentrations during transdermal nicotine treatment. Methods: Data were analysed from a smoking cessation study (n = 466), and from a pharmacokinetic study (n = 12). Multiple regression models examined the relationships of plasma concentrations to individual characteristics such as smoking pattern, absorbed dose of nicotine, and pharmacokinetic parameters. Results: Plasma concentrations of nicotine and cotinine were highly variable in both studies. Indirect estimates of plasma clearance (baseline plasma concentration divided by cigarettes per day) together with other factors could account for 18 to 33% of the variability during transdermal nicotine treatment in the smoking cessation study. In contrast, 75 to 99% was accounted for by direct measurements of plasma clearances and systemic dose of nicotine in the pharmacokinetic study. Conclusion: Plasma concentrations of nicotine and cotinine during transdermal nicotine treatment are poorly predicted by clinical history or baseline plasma concentrations. This is a result of inadequate characterisation of highly variable individual pharmacokinetic parameters and absorbed dose of nicotine. Considering the interindividual variability of plasma nicotine and cotinine concentrations together with the lack of clinical end-points for transdermal nicotine dosing, it seems logical to investigate the utility of a therapeutic drug monitoring approach for transdermal nicotine treatment – particularly for high dose regimens (〉 22 mg per 24 hours).
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 5 (2000), S. 0 
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY: The rate of dialysis uptake in Australia has been increasing and in 1996 was 77 per million people per year (pmp). The rate of kidney transplantation in Australia is at the same time falling. We have developed a computer model to enable predictions of the number of dialysis patients to 2007, under several scenarios of organ availability. We also aimed to examine the cost implications of the predictions. The number of existing and new dialysis and transplant patients was obtained from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) for the years 1988–95. Age-stratified transition coefficients for dialysis uptake, transplantation, graft failure and dialysis and transplant death were calculated for this time period. Data from 1995 were used as the baseline year in the application of the model and the calculated transition coefficients applied for this year. Scenarios of organ availability examined were the current trend continued, stabilization of the current Australian rate (23 pmp), the South Australian rate (35 pmp) achieved nationally and the Spanish rate (47 pmp) achieved nationally. Validation of the model using 1997 data was performed. Direct costs for dialysis and transplantation were obtained from a major teaching hospital in Melbourne. The number on dialysis is predicted to increase from 5648 in 1998 to 11 803 by 2007. If the transplant rate is increased from 23 pmp to ‘the world best practice transplantation rate’ (47 pmp) the predicted dialysis number in 2007 would be 8476. This is associated with a direct cost saving in comparison to the current trend of 82 million dollars (1998 Australian dollars). Assuming the Australian population increases as predicted and that current trends in dialysis uptake and transplantation continue, dialysis numbers are predicted to more than double over the next 10 years. In order to limit the potential human and economic cost of renal replacement therapy, this model indicates that attempts to increase organ availability are worthwhile.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 17 (1990), S. 0 
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. The diagnosis of isolated systolic hypertension, diastolic hypertension and normotension in elderly subjects, as defined by casual office blood pressure measurement, was compared with 24 h ambulatory blood pressure monitoring using an Accutracker II.2. Mean day-time ambulatory blood pressure monitoring underestimated the casual systolic blood pressure in all three clinical groups. Diastolic pressure was not underestimated to the same extent.3. Ambulatory blood pressure monitoring best reflected casual blood pressure determination for normotensive subjects. In subjects with isolated systolic hypertension ambulatory blood pressures were only consistent with that diagnosis for 8% of the day time period. For 34% of the day time, their ambulatory blood pressures were consistent with diastolic/ mixed hypertension.4. It is concluded that isolated systolic hypertension may not be a sustained condition, but rather an isolated response to office measurement of blood pressure.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. A precise and rapid gas chromatographic method for the measurement of plasma sodium valproate concentrations is presented.2. The extraction is a single step procedure, and is reproducible and linear throughout the concentration range encountered.3. Clinical evaluation of the drug is presented in eighteen epileptics on the basis of the percentage of days on which subjects had seizures before and after sodium valproate therapy.4. A tentative therapeutic range for sodium valproate is presented on the basis of plasma levels and therapeutic effect.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 19 (1992), S. 0 
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. Repeated clinic blood pressure measurement was compared with non-invasive ambulatory blood pressure (ABP) monitoring in 10 elderly subjects with isolated systolic hypertension (ISH) and 11 normotensive controls (NT).2. Subjects were assessed on four occasions at weekly intervals. None was receiving antihypertensive or vasoactive medication.3. Mean clinic blood pressure was consistently higher than mean daytime ABP in both clinical groups. This effect was greater for systolic (SBP) than diastolic blood pressure (DBP) and in the ISH group compared with the NT group. The reproducibility of the clinic minus ABP difference was high in both groups; the mean±s.d. of the differences was 26± 15/9 ± 2 mmHg in the ISH group and 7 ± 18/8 ± 9 mmHg in the controls.4. ABP readings were normally distributed for both SBP and DBP in both groups. In the ISH group, the frequency distribution of SBP readings was shifted to the right whilst the distribution of DBP readings overlapped that of the NT subjects.5. These results suggest a pressor response may largely account for the elevated SBP seen in elderly subjects with sustained ISH based on casual readings.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 19 (1992), S. 0 
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. This study investigated components of blood pressure variability in elderly subjects with isolated systolic hypertension (ISH) using both ambulatory blood pressure monitoring (ABPM) and casual clinic blood pressure measurement. These were then used to determine sample size requirements for clinical trials of different designs.2. Eleven elderly subjects not receiving antihypertensive medication were seen on four occasions at weekly intervals. On each occasion blood pressure was measured in the clinic and then for 24 h using a non-invasive ABPM device. Nested analysis of variance was used to calculate the ‘between subject’ and ‘between subject within occasion’ components of blood pressure variability.3. Increasing the number of readings or occasions where measurement was performed in a parallel group trial only reduced the variability substantially when the number of subjects involved was less than 50. Use of a cross-over design substantially reduced the sample size required.4. ABPM appears most useful as a strategy for reducing sample size in parallel group trials in ISH involving small numbers of subjects measured on one occasion.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Cardiovascular drugs and therapy 4 (1991), S. 1197-1201 
    ISSN: 1573-7241
    Keywords: hypertension ; elderly ; epidemiology ; drug therapy ; pathophysiology ; environment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In all but a few remote and unacculturated tribes, blood pressure rises with advancing age. By the time Western adult males or females reach their 70s their probability of being hypertensive (BP〉140/90 mmHg) exceeds 50%. Unlike various other risk factors for vascular disease, hypertension retains its predictive power as age increases, but since the baseline risk is higher, the number of cases of disease attributable to hypertension is much higher in the elderly than in the young. The reason for the rise in blood pressure with aging is not well established, although a high lifetime intake of sodium may be a contributing factor. It now appears that the major hemodynamic abnormality is an increased peripheral resistance. It is possible that an accentuation of changes that take place with normal aging might be responsible for this phenomenon. They include a reduction in renal function, decreased haroreceptor sensitivity, or increased sympathetic activity. Up until the present time studies have been unable to isolate the mechanisms involved.
    Type of Medium: Electronic Resource
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