Cardiac surgery and plasma digoxin levels.

Cardiopulmonary bypass (CPB) can induce several haemodynamic alterations and therefore influence pharmacokinetics of various drugs. In order to assess the effect of CPB on plasma digoxin levels, these were monitored in patients undergoing open heart surgery involving CPB (n = 11), over a 24 hour period, starting just prior to commencement of surgery. For comparison, plasma digoxin was also monitored in a group of patients (n = 10) who underwent cardiac surgery not involving CPB. In 7 of the 11 patients in the CPB group, plasma digoxin levels (ng/ml) were significantly (p < 0.01) lower at the end of 24 hours (0.654 +/- 0.094) than basal levels (1.3114 +/- 0.2498). In contrast, in the non CPB group, 7 of 10 patients showed significantly higher (p < 0.001) plasma levels (ng/ml) at the end of 24 hours (0.477 +/- 0.125) as compared to basal levels (0.26 +/- 0.098). Thus, rather than the type of surgery, it appears that the pre-operative levels of plasma digoxin influence its pharmacokinetics.

A multiple dose comparison of ketorolac tromethamine with ibuprofen for analgesic activity.

This study was done to compare a new analgesic ketorolac with ibuprofen in post-operative and post-laparoscopy pain. A total of 40 patients were recruited for the study of which 20 were post-operative and 20 were post-laparoscopy cases. Medication was given over a period of 48 hours after surgery and a pain score based on subjective symptoms was monitored at fixed intervals after each dose. The analgesic efficacy of ketorolac was found to be comparable to that of ibuprofen and the drug was well tolerated in the doses used without any extra medication being required.