Journal Article Considerations in Selecting a Mobile Master Medication Cart Get access Edward Superstine, Ph.D., Edward Superstine, Ph.D. Visiting Associate Professor Department of Pharmacy Practice, College of Pharmacy, The University of Utah, Salt Lake City. Search for other works by this author on: Oxford Academic Google Scholar Arthur G. Lipman, Pharm.D., Arthur G. Lipman, Pharm.D. Professor and Chairman Department of Pharmacy Practice, College of Pharmacy, The University of Utah, Salt Lake City. Search for other works by this author on: Oxford Academic Google Scholar Jan N. Bair, Ph.D., Jan N. Bair, Ph.D. Associate Professor Department of Pharmacy Practice, College of Pharmacy, The University of Utah, and Director of Pharmacy Services, University of Utah Hospital. Search for other works by this author on: Oxford Academic Google Scholar Sanford Baum, Ph.D. Sanford Baum, Ph.D. Professor Department of Mechanical and Industrial Engineering, and Director, Master of Engineering Administration Program, University of Utah. Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 40, Issue 2, 1 February 1983, Pages 293–297, https://doi.org/10.1093/ajhp/40.2.293 Published: 01 February 1983

Two epimeric aldehydes [(R)- and (S)-quinidinals] and the corresponding acids[(R)- and (S)-norhydroquinidinoic acids] were prepared by the oxidation of quinidine. The alpha-alpha interactions of the carbonyl group and the aromatic moiety, as reflected in the NMR spectra, were compared with those of quinidine. NMR spectroscopic analyses made it possible to assign both the stable conformation and their configuration at C-3 to these molecules. The free hydroxyl group at C-9 must be present for the chemical shift values to be concentration dependent. These findings provide more information on association in the parent molecules.

NMR analyses of quinidine and other cinchona alkaloids and their monoprotonated salts in deuterium oxide and in deuterochloroform revealed that the molecules assume new conformations in polar and nonpolar media, affecting the protonation site and hydrophilic-lipophilic characteristics. The ion-pair feature of the salts is lost and the molecules assume a neutral feature when they are transferred from an aqueous to a lipoid phase. Hydrophobic bonds-between the molecules and their environment and within the molecule itself may affect the binding of cinchona alkaloids to membranes in biological fluids.

1,3,4,14b-Tetrahydro-2,7-dimethyl-2H-dibenzo(b,f)pyrazino-(1,2-d)-(1,4)-oxazepine hydrogen maleate (Org GC 94) is an oral "antamine" preparation with anti-serotoninergic and anti-histaminic effects. Its lack of unpleasant side-effects permits protracted use for the preventive treatment of serotonin-migraine. Its chemical structure--tetracyclic ring, C-beta, C-alpha, amine in a secondary position--allows block of the receptors for serotonin and histamine. Preventive treatment with 3 x 5 mg/day of Org GC 94 for a period of 3 months can almost completely eliminate migraine attacks. 21 out of 30 patients (70%) profited from such a treatment, showing a drop from 5--30 attacks to 0--1 attack per month and normalization of high urinary serotonin, 5-HIAA or histamine levels. However, 30 patients receiving 3 x 0.5 mg or placebo daily reacted only rarely. The typical side-effects of anti-serotonin drugs, especially sedation or dizziness and hyperorexia were hardly observed. Randomization of the serotonin-migraine cases and double-blind methodology were applied throughout the trial.

Journal Article Drug interference with the phosphotungstate uric acid test Get access Shimona Yosselson-Superstine, Pharm.D., Shimona Yosselson-Superstine, Pharm.D. Lecturer in Clinical Pharmacy Department of Pharmacy School of Pharmacy Hebrew University Jerusalem, Israel Search for other works by this author on: Oxford Academic Google Scholar Dov Granit, M.Sc., Dov Granit, M.Sc. (Pharmaceutical Science), Clinical Pharmacist Department of Pharmacy Services Hadassah Medical Organization Jerusalem, Israel Search for other works by this author on: Oxford Academic Google Scholar Edward Superstine, Ph.D. Edward Superstine, Ph.D. Director Division of Pharmacy Services and Medical Supplies Hadassah Medical Organizatiorr Jerusalem, Israel Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 37, Issue 11, 1 November 1980, Pages 1458–1462, https://doi.org/10.1093/ajhp/37.11.1458 Published: 01 November 1980

The effect of theophylline on serum uric acid measurements was studied. Serum uric acid levels were measured by the phosphotungstate method in eight healthy adults, three of whom received a single u.3-mg/kg oral theophylline dose (as aminophylline elixir) while fasting, and in 15 fasting nonuremic patients (age 14 to 51 years) on chronic oral aminophylline therapy. Uric acid levels also were measured in vitro for serum with known amounts of theophylline (0-49 microgram/ml). Serum theophylline levels were measured by high-pressure liquid chromatography for the patients receiving chronic theophylline therapy and spectrophotometrically for the subjects receiving a single oral dose. In the 15 chronic theophylline patients, actual total serum uric acid levels were not significantly different (p greater than 0.05) from those expected had they been a normal population (i.e., healthy, not receiving theophylline). Likewise, in vitro studies showed no difference in uric acid levels of serum exposed to various concentrations of theophylline. A positive correlation (r greater than or equal to 0.816) between serum theophylline and uric acid levels was found in two of the three single-dose studies, suggesting a pharmacological interaction. Therapeutic serum theophylline levels do not interfere with the measurement of serum uric acid levels by the phosphotungstate method.

The information reported in a variety of sources on drug interferences with routine laboratory tests (serum concentrations of sodim, potassium, carbon dioxide, chloride, glucose, BUN, cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase, and SGOT) performed by a 12-channal autoanalyzer was reviewed. A determination was made whether or not the information was based on an evaluation of original articles, if the study was done in vitro or in vivo, what medium was used, if the drug level causing the interference would be encountered in a patient's serum, and if the reported conclusions were clinically significant. The review narrowed considerably the list of drug interactions with laboratory tests performed by 12-channel autoanalyzer methods. Clinically significant interactions were found for (1) aminosalicylic acid and the test for serum glucose; (2) gamma globulins and cholesterol measurement; (3) sulfonamides and paramethadione and the test for albumin; (4) albumin from placental sources and alkaline phosphatas measurement; (5) erythromycin estolate and aminosalicylic acid and the determination of SGOT; and, possibly (5) medications releasing bromide ions and the measurement of serum chloride. The study showed the need to determine the relevancy of drug interactions to the specific methods used in the laboratory of each medical institution.

SYNOPSISProxibarbal is a non‐sedative barbiturate with a specific anti‐serotonin and anti‐histamine effect, due to enzyme induction of serotoninase and histaminase. Its lack of unpleasant side‐effects permits its protracted use for the preventive treatment of migraine. Its chemical structure ‐ 5‐allyl‐5‐(beta‐hydroxy‐propyl)barbituric acid ‐ allows enzyme induction within 1–3 months of treatment. Preventive treatment with 1–3 × 100 mg/day proxibarbal for 3 months eliminated migraine attacks in 25 out of 35 cases (71%). In a double‐blind study of 30 female and 5 male patients, treatment with 3 × 100 mg/day produced a drop of from 5–30 attacks to 0–1 attack per month and normalization of high urinary serotonin, 5‐HIAA or histamine levels. The typical side‐effects of anti‐serotonin drugs and antihistaminics, especially sedation or dizziness and hyperorexia, were not observed. The mechanism of this effect was proved by accelerated and increased destruction of serotonin and histamine in vitro by the serum of the patients after treatment.

NMR spectra of quinidine (I), hydroquinidine (II), and their respective acetyl derivatives (III and IV) were compared. The chemical shifts of some protons in I differed from those of their counterparts in II. These values were concentration dependent in I and II; they were similar in III and IV but not concentration dependent. The implications of these findings and the correlation of the NMR data with the preferred conformations are discussed.

Annals of the New York Academy of SciencesVolume 301, Issue 1 p. 918-930 THE ADRENAL EXHAUSTION SYNDROME: AN ADRENAL DEFICIENCY* F. G. Sulman, F. G. Sulman Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this authorY. Pfeifer, Y. Pfeifer Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this authorE. Superstine, E. Superstine Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this author F. G. Sulman, F. G. Sulman Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this authorY. Pfeifer, Y. Pfeifer Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this authorE. Superstine, E. Superstine Bioclimatology Unit Department of Applied Pharmacology Medical Center, Hebrew University Jerusalem, IsraelSearch for more papers by this author First published: October 1977 https://doi.org/10.1111/j.1749-6632.1977.tb38258.xCitations: 2 * This work was supported by a grant from Mr. and Mrs. Herman Lane, New York. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume301, Issue1The Marathon: Physiological, Medical, Epidemiological, and Psychological StudiesOctober 1977Pages 918-930 RelatedInformation

The hemodynamic effects of dopamine were studied in 19 patients following intracardiac operation or myocardial revascularization using extracorporeal circulation. The heart rate, mean blood pressure, central venous pressure, left atrial and pulmonary artery pressures, cardiac output, and urine output were recorded before and at the end of one-hour infusions of dopamine at 5,10, and 15 μg/ kg/min. Infusion of 5μg/kg/min of dopamine resulted in the highest gain in cardiac output and stroke work without an increase in myocardial oxygen consumption, as evidenced by lack of significant rise in heart rate. In addition, this dosage was not accompanied by an increase in pulmonary or systemic vascular resistance, nor were other untoward effects observed after administration of 5 μg/kg/min of dopamine.

SYNOPSIS Danitracene is an oral antamine preparation; with three effects: anti‐serotoninic, anti‐histaminic and anti‐depressive. Its lack of unpleasant side effects permits its long use for the preventive treatment of migraine. Its chemical structure‐ring, C‐beta, C‐alpha, amine‐allows specific blockade of receptors for serotonin and histamine geared to the same configuration. Danitracene preventive treatment with 1‐3 x 0.5‐1 mgday for a period of 1‐3‐6 months can almost completely eliminate migraine attacks. Fifty out of 75 patients profited from treatment of 1‐3 x 0.5 mgday showing a drop from 5‐30 attacks per month to 0‐1 attacks per month. During this period 50 cases with high urinary excretion of serotonin, 5‐HIAA or histamine were normalized and relieved of their migraine attacks. Starting with very low doses at night overcomes the sedative anti‐serotonin effect, improves results and avoids dropouts. Two side‐effects typical for anti‐serotonin drugs were observed: sedation or dizziness and hyperorexia. The hypnotic effect tended to disappear after protracted treatment with one 0.5 mg doseday only. The hyperoraexia, however could only be overcome by reduced dosage. Randomization, “double‐blind” and cross‐over design were used in the trial.

Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or "forme fruste" hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: 1. tachycardia -- every case with more than 80 pulse beats being suspect (not specific); 2. urinary histamine -- every case excreting more than 90 mug/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; 3. urinary thyroxine -- every case excreting more than 20 mug/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and beta-blockers. Propyl thiouracil is rarely required.

Changes from normal weather to hot dry heat (Sharav) or cold rainy weather (Bora) evoked specific reactions of neurohormone secretion in 500 female weather-sensitive patients studied in Jerusalem (Israel). Urinary 17-KS increased only during the weather front period, whereas 17-OH increased steadily during the weather front and heat period. Adrenaline and noradrenaline decreased during both the weather front and the following heat period, clinically presenting all symptoms of adrenal medulla exhaustion. Serotonin increased during the weather front period and returned to normal thereafter, whether it was followed by a hot spell or a cold period, whereas 5-HIAA was increased throughout the weather front and hot period. Clinically, serotonin overproduction manifested itself as the serotonin irritation syndrome (migraine, etc.). Patients suffering from occult hyperthyroidism reacted with an increase of urinary thyroxine and histamine as soon as a weather front arrived with the clinical signs of slight hyperthyroidism, especially tachycardia. The serotonin irritation syndrome and the hyperthyroidism were prevented and cured by negative air ionisation treatment in 75% or 45% of the cases respectively.

Rabbits exposed for one hour to a temperature of 40degrees Cand 35-37% humidity showed elevated plasma osmolality and pH. Most of the animals were not able to withstand the heat. Dexamethasone-treated rabbits under the same conditions withstood the heat better and their plasma pH and osmolality remained constant. Metopirone-treated rabbits withstood the heat and showed a rise in plasma osmolality and a slight change in plasma pH. The highest rise in rectal temperature was observed in the metopirone-treated rabbits. Only the untreated animals were unable to regain pre-exposure rectal temperature. The results suggest that high levels of glucocorticosteroids enhance neurogenic and metabolic mechanisms which have protective functions during acute exposure to heat.

This chapter talks about the disturbances of homeostasis by heat stress or aging and its treatment with minidoses of MAO blockers. The chapter observes that elderly patients or young people when exposed to extreme climatic heat stress can suffer from lack of adrenaline and noradrenaline. This was shown by daily urinalysis. Having ascertained that the people were suffering from lack of monoamines, it was found that all the symptoms of catecholamine deficiency—for example, hypotension, fatigue, exhaustion, apathy, depression, lack of concentration, confusion, hypoglycemic spells, and ataxia. 300 patients for 5 years were treated with minidoses of MA0 blockers. A low dosage of 1/4-1 tbl/day completely cures the patients of their disability and adynamia, without any danger of a cheese tyramine reaction.

The pattern of use of antimicrobial agents in 1,700 patients hospitalized in a medical ward at the Hadassah University Hospital, Jerusalem, during 1969--72, is analyzed. Penicillins comprised 56%, tetracyclines 11%, streptomycin 9% and cephalosporins 3% of the total antimicrobial exposures. Ampicillin was given to 20% of the patient population. The use of tetracyclines and chloramphenicol fell steadily from 1969 to 1972. Fifty-five percent of the recipients of antimicrobial drugs received only one agent, 19% had concomitant therapy with several agents and the remainder received multiple antimicrobial drugs sequentially. One hundred and ten patients (6.5%) developed adverse reactions; the most common being rash and gastrointestinal reactions. Only two of the reactions were classified as causing major morbidity.

Hot dry winds (Sharav) produce increased ionisation of the atmosphere, values for positive and negative ions going up from an average of 1, 000 per cm3 to 1, 500. There was almost always a slight preponderance of the positively-charged small ions. This increased air ionisation induces serotonin release in about one-quarter of the population with multiple complaints of a typical serotonin irritation syndrome. In 75% of 129 subjects suffering from serotonin ailments, the treatment with negative air ions (Ionotron) with an output of 3.5 × 105 ions/(cm3 · sec) at 1 m distance produced prophylactic and therapeutic relief when the patients were kept in a room of up to 4 × 4 m size. These results were controlled by serotonin and 5-HIAA urinalysis.