The absorption of amoxycillin from the gastro-intestinal tract, with or without oral metoclopramide, has been evaluated. Levels of amoxycillin in the maternal blood and liquor prior to the induction of labour were of a therapeutic level against many organisms. However, absorption during labour, as reflected by maternal blood levels at delivery and cord blood levels, suggests that amoxycillin is poorly absorbed and may not reach adequate therapeutic levels in the fetus. Oral metoclopramide did not improve the absorption of amoxycillin. Should a parenteral form of amoxycillin become available, a similar study of blood and liquor levels may indicate that, like ampicillin, intramuscular administration is required for adequate therapeutic use at this stage of pregnancy. Until an oral formulation of an appropriate antibiotic is available which gives rapid absorption may and a sustained level of the chemotherapeutic agent in this situation, parenteral administration of an appropriate antibiotic remains mandatory.
A clinical study was performed on 41 asthmatic patients. After complete physical and spirometric examinations, they received capsules containing 200 mg anhydrous theophylline per capsule t.i.d. for three weeks. All other antiasthmatic medications were omitted during this study. The results showed that these capsules (Elixophyllin Capsules) produced statistically significant improvement in wheezing, dyspnea, global clinical assessment, vital capacity, and forced expiratory volume at 1 second. Side effects, which were generally mild and transient, were those usually reported for theophylline and were observed in 11 of the 41 patients. One patient dropped out of the study because of extreme nausea. It was concluded that theophylline as a single entity can provide significant improvement in asthmatic patients at a total daily dose of 600 mg.
Metaproterenol (Alupent), a new bronchodilator, was administered in oral and metered aerosol forms to 134 patients with bronchial asthma in three separate studies: (1) a placebo-controlled trial of single doses of aerosol, (2) a long-term uncontrolled clinical trial of the aerosol, and (3) a long-term uncontrolled clinical trial of the oral tablet. In the first study, statistical analysis of results in 31 patients showed that a single dose of metaproterenol aerosol was significantly superior to placebo aerosol in improving the pulmonary function as measured by forced expiratory volume (P less than 0.01) and maximum mid-expiratory flow rate (P less than 0.05). In the two uncontrolled, long-term clinical trials, 37 patients were treated with metaproterenol aerosol for an average of about four months, and 66 other patients received the drug orally for an average of about three weeks, respectively. The daily dose was one or two doses of aerosol, approximately 0.65 mg. per dose, taken as required several times daily; or 20 to 80 mg. of metaproterenol tablets daily orally. Satisfactory clinical response was seen in 29 (78.4 per cent) of the patients on aerosol and in 45 (68.2 per cent) of the patients on oral therapy. On the aerosol, nine patients (24.3 per cent) experienced mild tachycardia. On oral medication, side effects developed in 16 patients (24.2 per cent). Reactions, mostly nervousness and tachycardia, were mild and usually could be controlled by reducing the dosage. Only two patients (3 per cent) discontinued the drug. Laboratory tests carried out during the aerosol trial and at the end of the oral study revealed no drug-related abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
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