Intravenous treatment

In theory, one could utilise GC-A ligands to lower blood pressure and to reduce blood volume as they increase the excretion of water and salt. Nesiritide, human recombinant BNP, is the first member of this new class of drugs approved for the initial intravenous treatment of acutely decompensated congestive heart failure. Whether nesiritide can be a valuable addition to the standard therapy of decompensated heart failure remains to be demonstrated. 

A 27- year-old male with a three-year history of AIDS complains of progressive blurring of vision for two days. Eye examination reveals evidence of retinitis consistent with cytomegalic virus inclusion disease. Intravenous treatment is started, and within five days the patient complains of muscular weakness and cramping. Blood chemistries show a creatinine of. 5.2 mEq/L and a Ca of 6.9 mEq/L. 

The primary present-day indication for quinine and its isomer, qutnidine, is in the intravenous treatment of severe manifestations and complications of chloro-quine-resistant malaria caused by P. falciparum. 

Fenoldopam is a Di-receptor agonist that selectively leads to peripheral vasodilation in some vascular beds. The primary indication for fenoldopam is in the intravenous treatment of severe hypertension (Chapter 11). 

San Raffaele Telethon Institute for Gene Therapy is developing an adenosine deaminase transduced hematopoietic stem cell therapy for the potential intravenous treatment of adenosine deaminase deficiency in severe combined immunocompromised individuals (ADA-SCID). 

Kawalski H, Polanowicz U, Jonderko G, Kucharz EJ, Krol W, Klimmek K, Gina AR, Pieczyrak R, Slifirski J, Shani J. Immunological parameters and respiratory functions in patients suffering from atopic bronchial asthma after intravenous treatment with salmon calcitonin. Immunol Lett 1999 70(l) 15-9. 

Klebsiella pneumoniae infection in mice after intravenous treatment (Meisel and Schlimme, 1996). The mechanism by which milk protein derived peptides exert their immunomodulatory effects is not yet defined. However, opioid peptides may affect the immunoreactivity of lymphocytes via the opiate receptor. There is a remarkable relationship between the immune system and opioid peptides, because opioid p, receptors for endorphins are present on T lymphocytes and human phagocytic leukocytes (Meisel, 1998). 

For a severe hospital-treated community-acquired pneumonia, the BTS guidelines suggest intravenous treatment with a broad-spectrum beta-lactam such as co-amoxiclav or a second- or third-generation cephalosporin. In addition, a macrolide such as erythromycin or clarithromycin should be added to cover atypical bacteria. 

Seizures occurred in four of 50 patients receiving intravenous treatment. Those vulnerable to this complication... 

Cimetidine crosses the blood-brain barrier and can cause confusion, particularly in elderly or sick individuals with compromised hepatic or renal function, and especially after intravenous treatment. Very rarely an acute confu-sional psychosis has been seen in a younger person (161). Delirium has been thought to be a particular problem with intravenous use, but this is more likely to be a reflection of patient selection. Depression has occasionally been attributed to cimetidine (162,163). 

Both (31)(Fig. 10.9b) and (32) (Fig. 10.11) bind to the HIV-P active site asymmetrically. However, after the X-ray studies of crystalline HIV-P apoenzyme revealed it to be a symmetrical dimer, C2 symmetric inhibitors were designed to take advantage of this structural feature (Fig. 10.12). Both alcohol diamines and diol diamines were examined. For example, the C2 symmetric compound (33) (A-77003) was synthesized at Abbott and entered clinical trials as an antiviral agent for intravenous treatment of AIDS (100). 

Oral labetalol is well tolerated in pre-eclampsia, but if intravenous treatment is necessary, a small dose (5-10 mg) should be used initially and titrated up as necessary. 

Nervous system effects account for most adverse reactions to lorcainide after both intravenous and oral administration. During intravenous treatment patients may complain of vertigo, feeling hot, numbness of the feet (5), dizziness, blurred vision, muscle tremor (6), and tingling sensations in the fingers or tongue (7). All of these effects are transient. 

Shapiro J, Richardson GE. Pachtaxel-induced recall soft tissue injury occurring at the site of previous extravasation with subsequent intravenous treatment in a different hmb. J Clin Oncol 1994 12(10) 2237-8. 

Feldman C, White H, O Grady J, Flitcroft A, Briggs A, Richards G. An open, randomised, multi-centre study comparing the safety and efficacy of sitafloxacin and imipenem/cilastatin in the intravenous treatment of hospitalised patients with pneumonia. Int J Antimicrob Agents 2001 17(3) 177-88. 

After intravenous treatment of rats with 1200 mg/kg/d CPH for 3 days, homogenates of the renal cortex were separated into subcellular fractions and their protein composition analyzed. The results of the SDS-gel electrophoresis of the renal cortical subtractions showed significant alterations of the polypeptide pattern in the microsomal fraction. The analysis of the polypeptide composition of the microsomal fraction indicated that paralleling to the depletion of cytochrome P-450 isoenzymes in the molecular weight range 50-53,000 was the induction of a polypeptide of molecular weight 44,000 [74]. 

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