Pharmatherapeutica最新文献

A controlled trial was carried out in patients with biliary dyskinesia to compare the effects of the new calmodulin-independent and antispastic drug tiropramide with those of imecromone. Forty patients were randomly divided into two groups, one treated with 300 mg tiropramide per day and the other with 1200 mg imecromone per day, both treatments lasting for 3 months. The results showed that tiropramide was significantly more effective in decreasing the number of attacks of pain and in improving pain and dyspepsia symptoms than imecromone. In subjects with delayed filling of the gall bladder during cholecystography, tiropramide but not imecromone was able to normalize the condition. These results confirm the antispastic synchronizing effect of tiropramide on the motor activity of the gall bladder and the sphincter of Oddi and indicate that it should be the drug of choice for treatment of motor disorders of the biliary tract.

Sixty-one chronic asthmatic children received either a new slow-release sprinkle format of theophylline, twice daily, or theophylline liquid, 4-times per day. Over a study period of three months, there was no measurable difference in compliance or symptom control between the two groups. The sprinkle-treated patients, however, had a greater incidence of side-effects and had higher rates of nebulization with beta-agonists. Possible explanations are discussed.

A double-blind study was carried out in 54 patients requiring iron therapy to compare the effects of orally administered bivalent and trivalent iron over a period of 12 weeks. Patients were allocated at random to receive ferrous sulphate (100 mg/day), ferritin (80 mg/day as Fe3+) or a combination of ferritin (80 mg Fe3+/day), folinic acid and vitamin B12 coenzyme. Haematological measurements made before and during treatment showed that, whilst there were significant improvements in all of the parameters studied with both the bivalent and trivalent forms of iron, the results were more progressive and consistent with the two ferritin preparations, indicating that ferritin is clinically effective as a physiological iron donor in sideropaenic conditions.

A double-blind closed sequential scheme study was carried out in 82 patients with insomnia to compare the hypnotic effectiveness of 15 mg midazolam and 1 mg lorazepam. Pairs of randomized patients were treated on one and the same night with midazolam or lorazepam, respectively. Eight parameters were recorded for each member of the pair. The time taken to fall asleep, the duration of sleep and the overall assessment of response showed that midazolam was significantly superior to lorazepam: the number of awakenings and evaluation by the patient verged on statistical significance. Both drugs were equal for the quality of sleep, dreams and the patient's condition on awakening. No side-effects were observed in any of the patients.

Ninety-nine patients with secondarily infected eczema were allocated at random to receive 10-days' treatment with either 2% fusidic acid plus 0.1% betamethasone cream or 0.1% gentamicin plus 0.1% betamethasone cream. Both preparations were applied to the lesions twice daily and assessment of the signs and symptoms was carried out before, after 2 to 4 days, and after 7 to 12 days of treatment, severity being rated on a 4-point scale. Bacteriological tests were carried out before and after treatment. The results showed that the combination with fusidic acid was marginally superior in clinical effect. Staphylococcus aureus was the most commonly isolated pathogen from eczematous lesions (86%) and fusidic acid showed the lowest resistance rate (9%), followed by gentamicin (21%). Chloramphenicol, neomycin and tetracycline showed resistance rates from 48% to 59%.

A progressive study was carried out in 49 patients who underwent prostatectomy (10 transurethrally and 39 transvesically) to assess the effects of furosemide given intravenously for post-operative bladder irrigation. All 10 transurethral patients and 17 of the transvesical patients received furosemide, the remaining 22 patients receiving formal external bladder irrigation with saline. The results showed that post-operative infection was lowest and bed stay shortest in the patients with furosemide auto-irrigation. There was also less need for blood transfusion. No significant changes in haemoglobin and packed cell volume were observed in the transurethral patients; however, both decreased significantly in all 39 patients with transvesical prostatectomy, whether or not furosemide was used. Auto-irrigation with furosemide was found to be associated with a significant post-operative decrease in serum potassium but not in serum sodium levels. When external irrigation with saline was used, there was a significant increase in serum sodium.

Two new non-sedating antihistamines, astemizole (10 mg per day) and terfenadine (120 mg per day), were compared in a double-blind randomized study in 42 adult patients suffering from chronic urticaria. The trial lasted 4 weeks. Patients were evaluated at 2 and 4 weeks and kept a daily diary of their symptoms. There was a statistically significant decrease in pruritus, erythema and urticaria papules in both groups throughout the study. Changes in papule size, number and frequency were greater in the astemizole group though not significantly different to the terfenadine group. The effect of astemizole increased with time whereas that of terfenadine decreased after about 3 weeks of treatment. Astemizole was globally considered to be the most effective drug by both investigator and patients, with excellent/good results in 77% of the patients compared with 55% to 60% in the terfenadine group. Both drugs were reported to be more effective and faster acting than other antihistamines taken previously. Side-effects were infrequent and minor in both groups.

Forty-three out-patients received treatment (6 months in 13 cases of spondylarthrosis, 12 months in 30 cases of gonarthrosis) with heterologous antibodies to articular tissue, given as 1 rectal suppository once every other day for periods of 4 weeks out of every 5. The treatment produced complete freedom from symptoms and signs of the illness in 5 (12%) patients and overall positive therapeutic results in 36 (84%), equally distributed in the disorders of the vertebral column and of the knee. This was accompanied by a significant improvement, both in terms of percentage improvement and the percentage of patients improved, of all monitored symptoms. The percentage improvement was similar for all components of the illness: pain, mobility and inflammatory-reactive component. No local or systemic side-reactions were recorded throughout the observation period, and there were no adverse effects on haematology, haematochemistry or renal function. A high percentage of patients reported a remarkable improvement in their quality of life, an overall measure of the therapeutic benefit-risk ratio as experienced by the individual patient.

Fifty-three women with clinical evidence of vaginal candidosis confirmed by culture were entered into an open study. Patients received 400 mg ketoconazole once daily for 5 days. At 2 weeks post-treatment, 49 (92.5%) showed clinical and microbiological remission. The remaining 4 patients received 400 mg ketoconazole once daily for a further 21 days, along with a 400 mg 5-day course for their sexual partners. On completion of this second course of treatment, 3 of these patients were cured. Apart from some mild nausea, no side-effects were reported or observed.

In a group of 40 elderly patients with intellectual deterioration, slowing of behaviour was measured with an original reaction time apparatus. Three types of measurements in ascending degree of complexity were evaluated against each other. Intercorrelations, made with indicators of physical, mental and behavioural functioning, demonstrated that ascending complexity in reaction time measurements can be used as an evaluation of the degree of mental deterioration. An example of the use of the apparatus in the evaluation of the improvement after treatment with suloctidil is given.