Drugs online research references
J Clin Psychiatry. 1980 Jun;41(6):206-7.
Reliability of commercially available tricyclic antidepressant levels.
Amsterdam JD, Brunswick DJ, Mendels J.
Recent studies show that there may be a relationship between plasma levels of tricyclic antidepressants and clinical response. A number of commercial laboratories have introduced methods for measuring these drugs in plasma for clinical practice, and each recommends a particular method by which plasma samples should be drawn, processed, and stored. In this pilot study we compare results from 4 laboratories, using identical plasma samples containing amitriptyline and nortriptyline, in order to assess interlaboratory reliability. While there is generally good agreement between our results and those of the commercial facilities, some large interlaboratory discrepancies are evident. Caution is advised when utilizing plasma tricyclic levels to monitor patient progress, and we suggest using a laboratory which is well established in this area.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7380819&dopt=Abstract
Postgrad Med J. 1980;56 Suppl 1:112-4.
The prediction of tricyclic antidepressant plasma concentrations.
Braithwaite RA, Dawling S, Montgomery SA, McAuley R.
It is possible to predict steady-state plasma nortriptyline concentrations from pharmacokinetic data obtained after giving a single oral dose. The best pharmacokinetic predictor was found to be intrinsic clearance, although simpler kinetic criteria such as the 24, 48, or 72 hour plasma concentration were almost equally valuable. Use of such a tolerance test is a simple yet powerful way of obtaining advance information on individual differences in drug disposition. From such kowledge it should be possible to individualize drug dosage regimes so as to maximize antidepressant action, while at the same time minimizing the risk of toxicity. This test could be applied routinely in the psychiatric care of both inpatients and outpatients.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7393819&dopt=Abstract
Acad Emerg Med. 1994 Mar-Apr;1(2):111-5.
Recovery from severe cyclic antidepressant overdose with hypertonic saline/dextran in a swine model.
McCabe JL, Menegazzi JJ, Cobaugh DJ, Auble TE.
Division of Emergency Medicine, Thomas Jefferson University, USA.
OBJECTIVE: To determine the effect of a hypertonic saline and dextran (HSD) solution on blood pressure and QS duration during severe cyclic antidepressant (CA) toxicity in swine. METHODS: Ten domestic swine weighing 20-24 kg were anesthetized and placed on mechanical ventilation. Nortriptyline solution was infused intravenously to achieve hypotension (systolic blood pressure equal to 50% of baseline) and a QRS duration of 120 msec. After reaching toxicity, the animals received in a randomized fashion either 10 mL/kg of a 7.5% saline/6% dextran solution or an equal volume of 0.9% saline as a rapid intravenous bolus. The animals were observed for one hour or until they died. Blood pressure and ECG were recorded continuously. Arterial pH was maintained in the physiologic range by controlled ventilation. RESULTS: Mean systolic blood pressure 10 minutes after treatment was 45 +/- 8 torr in the normal- saline group compared with 115 +/- 12 torr in the HSD group (p < 0.05). Mean QRS duration 10 minutes after treatment was 180 +/- 8 msec in the normal-saline group; it was 88 +/- 13 msec in the HSD group (p < 0.05). All normal-saline--group animals died within 20 minutes, and four of the five animals in the HSD group survived to 60 minutes (p < 0.05). The mean peak sodium concentration was 157 mmol/dL (mEq/dL) in the HSD group, and this was transient. CONCLUSION: In this swine model of severe CA toxicity, a solution of 7.5% saline/6% dextran significantly reversed hypotension and QRS prolongation. HSD also improved survival to 60 minutes.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7542551&dopt=Abstract
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