Respiratory failure following oral administration of metoclopramide

OBJECTIVE: To report a case of respiratory failure, possibly due to anaphylaxis or asthma exacerbation, following the administration of metoclopramide. CASE SUMMARY: A 32-year-old white woman with a history of severe asthma and short-bowel syndrome was admitted for Hickman catheter line sepsis. Two doses of oral metoclopramide 10 mg in solution were administered for nausea and vomiting. Transient dyspnea followed the first dose of metoclopramide, but respiratory failure requiring intubation followed the second dose. DISCUSSION: Respiratory failure has been reported with metoclopramide-induced movement disorders. Three other cases of respiratory failure from anaphylaxis or asthma exacerbation following metoclopramide administration have been reported. Respiratory failure in our patient may be due to anaphylaxis or bronchoconstriction from metoclopramide-induced cholinergic activity of the vagus nerve, possibly through inhibition of acetylcholinesterase. CONCLUSIONS: The use of metoclopramide in patients with pulmonary dysfunction may warrant caution.     

Pharmacokinetics of doxycycline in pigs following oral administration in feed

Doxycycline medicated feed was administered to healthy fattening pigs for an 8-day period either for 1 h every 12 h or ad libitum. The average dosage regimen ranged between 11.8 and 13.3 mg/kg/day. Doxycycline concentrations were determined in plasma, lung and nasal mucosa using a high performance liquid chromatography assay (HPLC). The agreement between the doxycycline HPLC assay and a bioassay was also assessed in plasma. Following the multiple medicated feed administration every 12 h, the plasma concentrations were best described by a one-compartmental model with first-order absorption. Steady-state plasma concentrations ranged between 0.7 and 1 microgram/mL. The mean accumulation factor and elimination half-life were, respectively, 1.8 +/- 0.4 and 5.9 +/- 1.0 h. Following ad libitum administration of medicated feed, steady-state plasma concentrations ranged between 0.9 and 1.5 micrograms/mL. At the end of the treatment, the doxycycline lung and nasal mucosa concentrations were 1.7 +/- 0.4 micrograms/g and 2.9 +/- 0.6 micrograms/g, respectively. These data validate the dosage regimen tested in order to control pig respiratory infections, provided that controlled clinical studies are confirmatory.     

Induction of metallothionein-like cadmium-binding protein in the testis by oral cadmium administration in rats

PURPOSE: Intraorbital projectile metallic foreign bodies are associated with significant ocular and orbital injuries. The authors sought to evaluate epidemiologic factors, the incidence of associated ocular and orbital injury, and the nature and necessity of surgical intervention in these cases. METHODS: Charts of all patients with projectile intraorbital metallic foreign bodies seen at our institution (27) over the preceding 7 years were evaluated with respect to age, sex, type of injury, associated ocular and orbital injuries, location of the projectile (anterior, epibulbar, or posterior), postinjury visual acuity, and surgical intervention. RESULTS: The majority of patients were male, between the ages of 11 and 30, and had BB pellet injuries. Thirteen projectiles were lodged anteriorly, 4 were in an epibulbar position, and the remaining 10 were posterior to the equator. Twelve of 13 anterior, and 4 of 4 epibulbar foreign bodies were removed surgically, whereas only 2 of 10 posterior foreign bodies required surgery. No case of surgical intervention resulted in a decrease of visual acuity. Associated ocular injuries were both more common and severe in patients with posteriorly located foreign bodies. Final visual acuity was better at presentation and at discharge in patients with anteriorly located foreign bodies. CONCLUSION: Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. Management of these cases is dependent on the location of the projectile. Ancillary radiographic studies can be helpful. Surgery to remove the projectile should be considered in each case, but foreign bodies that are not readily accessible often may be left safely in place. Closer regulation of the pellet gun industry, with an emphasis on education and protective eyewear use, would be helpful in reducing these injuries.     

Kinetics of the colony-forming capacity of bone marrow cells following hydrocortisone administration to mice

A study was made of the dynamics of the colony-forming and migration capacity of the polypotent stem hemopoietic cells of the bone marrow of the F1 (CBA X C57BL) mice after the hydrocortisone administration. The relative count of the stem hemopoietic cells in the bone marrow increased on the 3rd day after the hydrocortisone administration. This elevation was maximal on the 5th day after the hydrocortisone administration. On the 8th day the stem hemopoietic cell count decreased to the normal level.     

Insulin and glucose response following oral glucose administration in well-conditioned ponies

Twenty-three well-conditioned ponies were evaluated for insulin and glucose response following oral glucose administration (1 g/kg bodyweight [bwt] as a 20 per cent solution). Ponies were defined as normal if total insulin secretion (TIS) was less than 149 mu iu/ml h and the glucose concentration was below 11.1 +/- 0.11 mmol/litre (200 +/- 2 mg/dl) at all times following oral glucose administration. When glucose concentrations were maintained below 11.1 +/- 0.11 mmol/litre, the area under the glucose curve (TG) was less than 17.4 mmol/litre/h (314 mg/dl/h). The ponies were assigned to four groups based on insulin and glucose response: Group 1 (n = 7), normal; Group 2 (n = 5), high insulin, normal glucose; Group 3 (n = 8), high insulin, high glucose and Group 4 (n = 3), high glucose, normal insulin. This classification is an initial attempt to define normal insulin and glucose response in ponies. Additional data need to be accumulated to define further insulin resistance and diabetes in ponies.     

Cadmium accumulation in liver and kidney of mice exposed to the same weekly cadmium dose continuously or once a week

Cd levels in blood, liver and kidney of female mice were measured after exposure to Cd as CdCl2 in the food, either continuously (CE group) throughout the week (300 microg Cd/kg feed) or for 24 hr/wk (2100 microg Cd/kg) for 5 wk (occasionally exposed, OE group). In a control group that received feed with Cd levels below the detection limit (< 7 microg/kg), Cd levels in blood, liver and kidneys were below the detection limit after the 5 wk of exposure. The weekly dose of Cd administered to the exposed CE and OE groups was similar (approx. 400 microg Cd/kg mice/wk). The OE group had a higher Cd level in blood and a higher fractional accumulation (% of dose) of Cd in the liver and kidneys compared with the CE group. This indicates that the fractional Cd absorption in the gastrointestinal tract is higher when high Cd doses are ingested occasionally than when low doses are ingested continuously, even if weekly doses are the same. It is hypothesized that this difference in absorption could be due to Cd-induced unspecific damage to the intestinal mucosa, changes in tight-junction permeability caused by Cd, or to a saturation of the Cd-binding capacity of the intestinal mucosa in mice exposed to high Cd levels occasionally.     

Changes in hepatic enzyme activities related to ethanol metabolism in mice following chronic ethanol administration

Male mice of three strains, C57BL, DBA and C3H/He, were fed on commercial food with 10% (v/v) ethanol solution as drinking liquid ad libitum for eighty days, and the changes in the activities of enzymes in the metabolic pathway of ethanol in the liver were examined. C57BL and C3H/He mice showed a preference for drinking the 10% (v/v) ethanol solution, while DBA mice did not. The ethanol intake g/g of body weight of C3H/He mice showed the highest value among all three strains and that of C57BL mice tended to show higher value than that of DBA mice. The liver weights of C57BL and C3H/He mice increased significantly following chronic ethanol administration, but that of DBA did not. The cytosolic enzyme alcohol dehydrogenase (ADH) showed no changes in any of the strains following chronic ethanol administration. The microsomal ethanol-oxidizing system (MEOS) of C57BL mice exhibited approximately 2-fold higher activity compared to that of DBA and C3H/He mice but did not increase in any strain following chronic ethanol administration. However, the microsomal aniline hydroxylase activity in the liver increased significantly in C57BL and C3H/He mice following chronic administration of ethanol. The microsomal cytochrome P-450 content also tended to slightly increase in the same strains of mice. It seemed that cytochrome P-450IIE1 was induced in the liver microsomes of these strains. Total aldehyde dehydrogenase (ALDH) activities together with high-Km ALDH activity increased markedly in the microsomes of C57BL mice and tended to increase in C3H/He mice, while it did not change in DBA mice following chronic ethanol administration. In the mitochondria of C57BL, total ALDH activities increased slightly and high-Km ALDH activities tended to increase. These mitochondrial ALDH activities of C3H/He and DBA mice tended to increase following chronic ethanol administration. The cytosolic ALDH activity showed no changes in any strain of mice following chronic ethanol administration. It seemed that in the microsomes, the activities of enzymes related to oxidation of ethanol increased in C57BL and C3H/He mice, which tended to consume a large amount of ethanol, and did not in DBA mice which tended to consume a small amount of it. It seemed that the increases in activities of enzymes related to oxidation of acetaldehyde in the microsomes and in the mitochondria were responsible for the strain difference.     

Comparative plasma concentrations of quinidine following administration of one intramuscular and three oral formulations to 13 human subjects

A GLC method, based on flame-ionization detection, was developed for the assay of methotrimeprazine and its sulfoxide in plasma. For a 6-ml aliquot, the sensitivity was 2-3 ng/ml for the unchanged drug and 4-5 ng/ml for the sulfoxide. The coefficient of variation, calculated from duplicate analyses of plasma samples, was 8-15% for concentrations between 10 and 100 ng/ml. Patients treated with orally administered methotrimeprazine had higher plasma levels of the sulfoxide than of unmetabolized drug. The method also was applied to the analysis of promazine and chlorpromazine in patient plasma.     

Explorative and drinking behavior after prolonged access to alcohol and following chronic piracetam administration in mice

Male mice with free access to food, water, and alcohol for 44 weeks were deprived of alcohol for 3 days and then segregated into two groups having (HD) and lacking (LD) the alcohol deprivation-induced elevation in intake. On week 47, the HD and LD groups (divided into subgroups matched for drinking) received either vehicle or piracetam (400 mg/kg) for 10 days. On the last treatment day, alcohol was again withheld. Cross-maze exploration and drinking pattern were evaluated on the first and third postinjection days. Control mice, having had no previous access to alcohol, were subjected to the same treatment and tests. There were a greater number of vehicle-treated HDs displaying arm reentries than LDs or alcohol-naive control mice. Further, the control mice drank less alcohol than HDs during the first 1.5 h of renewal access, and more water than the HD or LD group during the remaining 22.5 h. Piracetam improved maze patrolling and arm reentries in alcohol-naive mice, but did not change these measures in HDs and LDs. No effect of piracetam on drinking parameters was revealed.     

Age-related differences in norfloxacin pharmacokinetic behaviour following intravenous and oral administration in sheep

The pharmacokinetics of norfloxacin after intravenous (i.v.) and oral (PO) administration in lambs (n = 5) and adult sheep (n = 5) were studied. After i.v. administration (10 mg.kg-1) plasma concentrations were best fitted by a three-compartment open model in both age groups. Distribution volumes were significantly larger in lambs (approximate 4.0 fold difference between 4 week old and adult sheep). There was no significant difference (p < 0.05) between the groups in terms of elimination halflife but plasma clearance was significantly higher in lambs. Norfloxacin was poorly absorbed after oral administration (60 mg.kg-1) in sheep (F = 4.04%). Mean oral bioavailability was 73.51% in lambs (30 mg.kg-1). Norfloxacin elimination was faster in lambs after oral administration. MRTt was significantly prolonged in both age groups when compared with the respective data for i.v. administration.     

Pharmacokinetics of phenprobamate after oral administration to healthy subjects

Phenprobamate (CAS 673-31-4) is a centrally acting skeletal-muscle relaxant agent. There are only two studies in the literature about the pharmacokinetics of phenoprobamate in man. The inconsistency between the results of these studies can be attributed partly to the different analytical methodologies used. A sensitive, specific and reproducible HPLC-assay, which may increase the reliability of the pharmacokinetic studies of phenprobamate in plasma, has been developed recently. The objective of this investigation was to assess the single-dose kinetics of phenprobamate in human and to determine the pharmacokinetic parameters of clinical and regulatory concern. The plasma pharmacokinetics of phenprobamate have been investigated following single oral administration at a dose of 800 mg in eleven healthy volunteers.     

Hepatic and renal metallothionein induction following single oral administration of gallium arsenide in rats

Metallothionein genes (MT) are inducible by a variety of agents, including heavy metals. We report the induction of MT expression by gallium arsenide (GaAs), a superior intermetallic semiconductor material at two time intervals following single oral exposure in rats. The data is also supplemented with two additional groups exposed to gallium (III) as gallium oxide and arsenic (III) as sodium arsenite to determine which of the two moieties in GaAs is responsible for any such possible effects. The results indicate that GaAs administration does significantly induces MT in hepatic tissues accompanied by an increase in cytosolic glutathione, arsenic, zinc and copper concentration. It thus proves that arsenic moiety is chiefly responsible for such an effect.     

Tissue residues of dietary cadmium in wood ducks

One-week-old wood ducks were fed cadmium in diets containing 18 or 30% protein for a period of three months. Seven drakes from each group were sacrificed, and blood, brain, muscle, kidney, liver, and wing feather tissues were collected and analyzed for cadmium. Highest cadmium concentrations were found in the kidney, liver, and feather tissues; blood, muscle, and brain cadmium residue levels were undetectable. Except in the kidney tissue, protein level of the diet did not affect cadmium residue levels. For birds that were changed to a cadmium-free, high-protein ration at 13 weeks of age, regression analysis indicated a significant decrease in cadmium residue levels for the kidney tissue only. Growth, as measured by bodyweight at 13 weeks of age, was not affected by the various cadmium treatment levels. Histopathological examination revealed lesions in the kidney tissues of the 100 ppm cadmium treatment groups, which were more severe in those birds receiving the 18% protein diet. Vacuolation of the pancreatic acinar cells was observed in all groups, but tended to occur more frequently in the higher cadmium level groups.     

Fecal recovery following oral administration of Lactobacillus strain GG (ATCC 53103) in gelatine capsules to healthy volunteers

Recovery of the suggested probiotic strain Lactobacillus GG in feces was studied after oral administration. Lactobacillus GG was given to 20 healthy human volunteers for 7 days in gelatine capsules with daily doses of 1.6 x 10(8) cfu and 1.2 x 10(10) cfu. All the volunteers in the higher dose group had detectable numbers of Lactobacillus GG in their feces during the test period. The strain was detected in feces of all the volunteers after 3 days of administration. No effect was observed on the total number of fecal lactobacilli. Fecal detection of the strain may facilitate dose-response studies and provide a useful tool in dietary studies utilizing the strain in foods or food-type products.     

Age dependent accumulation of cadmium in the human ovary

In an eight years old boy we operated an intramedullary astrocytoma grade I and reimplanted the laminae C4-7 en bloc. A good stability was achieved. Ten years later only one segment remained intact, the others showing spontaneous fusion as a major draw back. This is possibly due to subperiostal dissection and bracing. No spinal stenosis occurred. An overuse of the remaining disc C4/5 might lead to a secondary degenerative stenosis. The operation is simple and might avoid swan neck deformity in children after large decompression of dorsal structures.     

Augmentation of natural killer cell activity in mice by oral administration of transforming growth factor-beta

OBJECTIVE: To analyze the effect of HLA-DR genes on susceptibility to and severity of ankylosing spondylitis (AS). METHODS: Three hundred sixty-three white British AS patients were studied; 149 were carefully assessed for a range of clinical manifestations, and disease severity was assessed using a structured questionnaire. Limited HLA class I typing and complete HLA-DR typing were performed using DNA-based methods. HLA data from 13,634 healthy white British bone marrow donors were used for comparison. RESULTS: A significant association between DR1 and AS was found, independent of HLA-B27 (overall odds ratio [OR] 1.4, 95% confidence interval [95% CI] 1.1-1.8, P = 0.02; relative risk [RR] 2.7, 95% CI 1.5-4.8, P = 6 x 10(-4) among homozygotes; RR 2.1, 95% CI 1.5-2.8, P = 5 x 10(-6) among heterozygotes). A large but weakly significant association between DR8 and AS was noted, particularly among DR8 homozygotes (RR 6.8, 95% CI 1.6-29.2, P = 0.01 among homozygotes; RR 1.6, 95% CI 1.0-2.7, P = 0.07 among heterozygotes). A negative association with DR12 (OR 0.22, 95% CI 0.09-0.5, P = 0.001) was noted. HLA-DR7 was associated with younger age at onset of disease (mean age at onset 18 years for DR7-positive patients and 23 years for DR7-negative patients; Z score 3.21, P = 0.001). No other HLA class I or class II associations with disease severity or with different clinical manifestations of AS were found. CONCLUSION: The results of this study suggest that HLA-DR genes may have a weak effect on susceptibility to AS independent of HLA-B27, but do not support suggestions that they affect disease severity or different clinical manifestations.