Chemical patients

Sulfonylureas. The hypoglycemic effect of sulfonylureas was first noted in the early 1940s when several patients died in hypoglycemic coma after testing glyprothia2ole, a synthetic sulfonamide used to treat typhoid. Chemical modifications which enhanced activity and lowered toxicity led to the development of the first-generation sulfonylureas. Carbutamide [339-43-5] the first commercial sulfonylurea, came onto the European... 

The development of so-called photodynamic therapy uses lasers for treatment of cancer. The patient is injected with a substance called hematoporphyrin derivative [68335-15-9] which is preferentially localized in cancerous tissues. The patient is later irradiated with laser light, often with a dye laser at a wavelength around 630 nm. The light energy catalyticaHy photooxidizes the hematoporphyrin derivative, releasing materials which kill the nearby cancerous tissue. Normal tissue which did not retain the chemical is not harmed. Photodynamic therapy offers promise as a new form of cancer treatment. 

In common with other pharmaceuticals, the two primary requirements for success are safety and efficacy. Safety is deterrnined both by chemical toxicity and radiation dose deflvered to the patient. 

Chemical Toxicity. Radiopharmaceuticals are subject to the same requirements for safety as are other pharmaceuticals, and are tested for chemical toxicity in much the same manner. It is generally understood, however, that patients are likely to receive relatively few doses of any given radiopharmaceutical so that the effects of long-term chronic exposure to the compound rarely need be assessed. Safety margins, that is, the ratio of the adininistered dose to the lowest dose that produces an observable effect, are usually on the order of 100 or more. 

Monoamine Oxidase Inhibitors. MAOIs inactivate the enzyme MAO, which is responsible for the oxidative deamination of a variety of endogenous and exogenous substances. Among the endogenous substances are the neurotransmitters, norepinephrine, dopamine, and serotonin. The prototype MAOI is iproniazid [54-92-2] (25), originally tested as an antitubercular dmg and a close chemical relative of the effective antitubercular, isoniazid [54-85-3] (26). Tubercular patients exhibited mood elevation, although no reHef of their tuberculosis, following chronic administration of iproniazid. In... 

Sutures are required to hold tissues together until the tissues can heal adequately to support the tensions exerted on the wound duting normal activity. Sutures can be used ia skin, muscle, fat, organs, and vessels. Nonabsorbable sutures are designed to remain ia the body for the life of the patient, and are iadicated where permanent wound support is required. Absorbable sutures are designed to lose strength gradually over time by chemical reactions such as hydrolysis. These sutures are ultimately converted to soluble components that are then metabolized and excreted ia urine or feces, or as carbon dioxide ia expired air. Absorbable sutures are iadicated only where temporary wound support is needed. 

Miscellaneous Agents. Those chemotherapeutic agents, which do not fit into any of the classifications discussed, ate Hsted iu Table 7. Mitotane (67), a stmctural isomer of DDT, is used to iaduce chemical adrenalectomies iu patients having adrenal cancer by teduciug host levels of adrenocorticosteroids. 

A liquid chromatography-mass spectrometry (LC-MS) method that can quantitatively analyze urinar y normal and modified nucleosides in less than 30 min with a good resolution and sufficient sensitivity has been developed. Nineteen kinds of normal and modified nucleosides were determined in urine samples from 10 healthy persons and 18 breast cancer patients. Compounds were separ ated on a reverse phase Kromasil C18 column (2.1 mm I.D.) by isocratic elution mode using 20 mg/1 ammonium acetate - acetonitrile (97 3 % v/v) at 200 p.l/min. A higher sensitivity was obtained in positive atmospheric pressure chemical ionization mode APCI(-i-). 

The patient may suffer from shock, in proportion to the extent of the injury. Give small drinks and keep warm do not overheat. In all cases, speed of treatment is crucial to limit the effects of burns. Flowcharts which summarize the initial procedures for electrical, thermal and chemical burns respectively are shown in Figure 13.5. 

Health Hazards - Personal Protective Equipment Full face mask and acid gas canister self-contained breathing apparatus chemical goggles mbber apron and gloves acid-proof clothing safety shower Symptoms Following Exposure Severely irritating to nose and upper respiratory tract lung injury Treatment for Exposure INHALATION immediately remove patient to fir h air, keep him warm and... 

---