New Stick Test for P.A.S. in Urine

Luntz, G. R. W. N.; Austin, Raymond

doi:10.1136/bmj.1.5187.1679

Cited by 62 publications

(11 citation statements)

References 19 publications

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“…Indeed, all four regimens in the present study appear to have been of the same order of acceptability. As in previous studies (Wynn-Williams & Arris, 1958;Tuberculosis Chemotherapy Centre, 1959;Luntz & Austin, 1960;Velu et al. 1960 2), there was evidence of greater irregularity in drug-taking among the females than among the males.…”

Section: Peripheral Neuritissupporting

confidence: 57%

A concurrent comparison of isoniazid plus PAS with three regimens of isoniazid alone in the domiciliary treatment of pulmonary tuberculosis in South India

&NA;¹

1962

Nursing Research

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TUBERCULOSIS CHEMOTHERAPY CENTRE, MADRASRecent studies have shown that treatment of pulmonary tuberculosis with isoniazid plus p-aminosalicylic acid (PAS) at home is, in the majority of cases, as satisfactory as treatment with the same combination ofdrugs in sanatorium and does not appear to expose the patient's contacts to any special risk. Before mass domiciliary chemotherapy can be introduced, however, a question that has to be decided is what drug or drugs and what dosage and rhythm of administration will be most effective.This paper presents the results of a controlled comparison offour chemotherapeutic regimens: (a) 3.9-5.5 mg/kg body-weight of isoniazid plus 0.2-0.3 g/kg body-weight of PAS (sodium salt) daily in two doses (the standard combined chemotherapy); (b) 7.8-9.6 mg/kg body-weight of isoniazid alone daily in one dose; (c) 7.8-9.6 mg/kg body-weight of isoniazid alone daily in two doses; (d) 3.9-5.5 mg/kg body-weight of isoniazid alone daily in two doses. Isoniazid plus PAS proved to be the most satisfactory regimen; it was clinically effective and there were very few toxic manifestations.

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Section: Peripheral Neuritissupporting

confidence: 57%

A concurrent comparison of isoniazid plus PAS with three regimens of isoniazid alone in the domiciliary treatment of pulmonary tuberculosis in South India

&NA;¹

1962

Nursing Research

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“…One might have expected that a symptomatic illness such as obstructive airways disease would encourage compliance, but so many patients were receiving theophylline in amounts which produced plasma levels below 10 jig/ml or even below 5 ug/ml that it seems unlikely that failure to take the drug would result in symptomatic deterioration. It has previously been shown that, where immediate symptomatic worsening is unlikely to follow drug withdrawal, as in hypertension (Haynes, 1979) or in tuberculosis (Luntz & Austin, 1960), drug defaulting may be common.…”

Section: Discussionmentioning

confidence: 99%

Patient compliance with oral theophylline therapy.

Taylor¹,

Kinney²,

McDevitt³

1984

Brit J Clinical Pharma

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1 Day-to-day variations in plasma theophylline concentrations at steady-state have been assessed in 29 hospital inpatients who required theophylline for obstructive airways disease. Plasma concentrations were measured at 09.00h and 14.00h for four consecutive days in the equilibrium state in 13 patients taking 350 mg/day and 16 patients taking 700 mg/day. 2 Analysis of variance gave 95% confidence limits for day-to-day variation of + 2.9 ,ug/ml at 350 mg/day and + 4.8 ,ug/ml at 700 mg/day.3 In a separate study, compliance with sustained-release theophylline therapy has been assessed in a group of 63 patients receiving the drug in general practice but not attending hospital. Compliance was estimated by comparing plasma theophylline concentrations before and after a 7-day period of measured theophylline consumption and by tablet counting. 4 Of the 63 patients, 16 had discontinued their theophylline prior to being contacted and two did so during the first week: these were considered non-compliant. 5 Three patients had plasma concentrations which increased by more than the day-today variation for their dose level during monitored intake and one other took less than 80% of his tablets. These patients were also considered non-compliant. A further four patients in whom plasma theophylline levels were zero on at least one occasion during the study were also adjudged non-compliant. 6 Thus non-compliance with prescribed theophylline dosage occurred in 26 (41.3%) of the patients studied. In the majority of these, treatment had been discontinued and the non-compliance was gross. 7 Due to normal day-to-day variations, plasma theophylline concentration measurement does not appear to be a useful method of assessing compliance in patients taking maintenance theophylline therapy.

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“…In two groups of tuberculous out-patients prescribed P.A.S. urine tests indicated failure rates of 50% (Dixon et al, 1957) and 30-40% (Luntz and Austin, 1960), higher values being related to length of treatment in the latter study. Two reports on schizophrenic out-patients (Parkes et al, 1962 ;Renton et al, 1963) quote rates of 44-46% obtained by inquiry.…”

mentioning

confidence: 62%

Coarctation of thoracic aorta, with thrombosis of arch, treated by homograft.

Nicks¹

1965

BMJ

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A patient who is prescribed drugs may take none of them, or he may take them for a short time and then stop, or he may take them irregularly. The answer to the question, " Is this patient taking his drugs ? " will depend on the criterion used. A verbal inquiry can compass some or all of the various ways in which a patient may not take his drugs. Urine tests for drug excretion give restricted answers, but have the advantage of objectivity, an advantage of particular importance in this context. In the present study a negative urine test for amphetamine-like substances (including a negative chromatogram where low dosage of chlorpromazine made the first test unsatisfactory) indicates that the patient had not been taking the drug during the previous 24 hours (or longer for imipramine patients according to dose). This might mean only a temporary and isolated lapse in taking his tablets, though sometimes of significant duration. The findings, however, that a second urine test usually gave the same result as the initial one, and that in multiple tests the results from any patient were usually consistent, suggest that a single negative test may generally be taken to indicate that the patient had not been taking his drug at all, or not with any regularity, for many days or weeks.The use of this criterion has demonstrated a failure rate of 48% in the whole series. This may be compared with failure rates of over 20% (Haler, 1962) and 33-40% (Benstead and Theobald, 1952) Our findings do little to elucidate the reasons why patients omit their drugs. Age, sex, intelligence, and side-effects had no apparent influence. The fact that men living alone defaulted more often than those living with their wives suggests a beneficial influence of supervision. The failure rate varied with diagnosis and with the drug, but our observations suggest no simple explanation.While the causes may remain obscure, the fact seems to be established that a very large proportion of psychiatric outpatients fail to take their drugs. Some consequences of the extent of this failure may be mentioned. There is a considerable waste of drugs and money. The accumulation of unused drugs in the homes of patients is a source of danger. Drug trials in which there is no reliable check on whether the patients are taking the drugs as prescribed can be seriously misleading. SummaryTests were made of 125 psychiatric out-patients to ascertain whether they were taking the chlorpromazine or imipramine that had been prescribed.Criteria of failure to take the drugs were based on information of the drugs' excretion by in-patients, and included both a quantitative test and sensitive and specific chromatographic tests.The results indicate that the failure rate for the whole series was 48 %. The rate for patients prescribed chlorpromazine was slightly higher than that for those prescribed imipramine, and was also higher for depressives than for schizophrenics within the chlorpromazine group.Failure rate was not associated with age, sex, intelligence, or drug side-effects.The...

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New Stick Test for P.A.S. in Urine

Cited by 62 publications

References 19 publications

A concurrent comparison of isoniazid plus PAS with three regimens of isoniazid alone in the domiciliary treatment of pulmonary tuberculosis in South India

A concurrent comparison of isoniazid plus PAS with three regimens of isoniazid alone in the domiciliary treatment of pulmonary tuberculosis in South India

Patient compliance with oral theophylline therapy.

Coarctation of thoracic aorta, with thrombosis of arch, treated by homograft.

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