Blood cases

Point-of-Care Testing Blood Cases and Blood Electrolytes with Portable Instrumentation... 

Acts to constrict small arteries, thereby increasing blood pressure and to contract smooth muscle. Used in cases of peripheral vasomotor collapse. 

Alcohol. The number of driving under the influence of alcohol (DUl) cases reflects the enormity of the dmnken driving problem in the United States (9). Tests to measure blood alcohol concentration are conducted on blood, urine, or breath (10). In the case of urine and breath, the alcohol concentration measured is reported in terms of the equivalent blood alcohol concentration. Most states in the United States presume that a person is under the influence of alcohol with respect to driving a motor vehicle at a blood alcohol concentration of 0.10%, ie, an ethanol concentration >10 g/100 mL of blood. Some states maintain a lower necessary concentration of 0.08%. In some European countries levels are as low as 0.05%. A blood alcohol concentration of 0.10% in a 68-kg (150-lb) person is the equivalent of about four drinks of 80 proof alcohoHc beverage or four 340-g (12-oz) beers in the body at the time of the test (see Beer Beverage spirits, distilled Wine). Ethanol is metabolized at the equivalent rate of about one drink per hour. 

Other Substances. Driving under the influence of alcohol cases are compHcated because people sometimes consume alcohol with other substances (11—13). The most common iUicit substances taken with alcohol are marijuana and cocaine (see Table 1) (14). In combination with alcohol, some dmgs have an additive effect. When a blood or urine alcohol sample is tested for alcohol and the result is well below the legal concentration threshold yet the test results are not consistent with the arresting officers observation that the subject was stuporous, further toxicological tests for the possible presence of dmgs are indicated. 

In some cases, density gradient solutions are used to separate a specific layer of cells. A solution, like FicoU or PercoU, with a mass density between the density of the cells that are to be collected and the other cells, is added to the blood product. 

Table 11 summarizes values for the median lethal dose (LD q) for several species. In case of massive exposure, convulsions must be controlled, and glucose, fluid balance, and uriaary output must be maintained. Medical surveillance requires checking for damage to the Hver, the organ that apparently sustains initial damage, and monitoring for changes ia the blood profile. 

NIDDM is a much more common disease than IDDM, accounting for about 85—90% of all cases of diabetes meUitus. Whereas NIDDM may be present at any age, the incidence increases dramatically with advanced age over 10% of the population reaching 70 years of age has NIDDM. Patients with NIDDM do not require insulin treatment to maintain life or prevent the spontaneous occurrence of diabetic ketoacidosis. Therefore, NIDDM is frequendy asymptomatic and unrecognized, and diagnosis requires screening for elevations in blood or urinary sugar. Most forms of NIDDM are associated with a family history of the disease, and NIDDM is commonly associated with and exacerbated by obesity. The causes of NIDDM are not well understood and there may be many molecular defects which lead to NIDDM. 

In cases of all but intravenous adininistration, dosage forms must make the active moiety available for absorption, ie, for dmg release. This influences the bioavailabiUty and the dmg s pharmacokinetic profile. Ideally the dmg is made available to the blood for distribution and elimination at a rate equal to those processes. Through technological developments dmg product design can achieve release, absorption, and elimination rates resulting in durations of activity of 8—12 hours, ie, prolonged action/controlled release dmg products (21,22). Such products improve the compliance rate of dmg usage by patients. 

Aerosol adniinistration of isoproterenol produces a prompt (2—5 minutes) intense bronchodilatation of relatively short (1 h) duration. The lack of P2-selectivity leads, in many cases, to tachycardia and blood pressure elevation. Also, use of isoproterenol, like all other known P-agonists, results in a down-regulation, or desensitization, of P-adrenergic receptors. This desensitization is only partial, and after time (depending on dose, patient, and agent), a stable, less responsive state is achieved in which P-agonists remain effective. Isoproterenol has been widely used for many years. 

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