Similar efficacy of nitrendipine in young and elderly hypertensive patients.

Calcium channel blockers have been postulated to be more effective as monotherapeutic antihypertensive agents in the elderly than in younger patients. To determine if a new dihydropyridine derivative, nitrendipine, is more effective in the elderly (older than 60 years) than in younger hypertensive subjects (younger than 60 years), nitrendipine was administered in a multicentered study to 21 elderly and 33 younger subjects with essential hypertension. After gradual discontinuation of previous antihypertensive therapy and 2 weeks of placebo, the daily dose of nitrendipine (10 to 40 mg) was titrated over 3 weeks to achieve a 10 mm Hg decrease in supine diastolic blood pressure (BP) for patients entering with 90 to 99 mm Hg. For patients entering with at least 100 mm Hg, the dose was titrated to diastolic BP no greater than 90 mm Hg. Titrated dose of nitrendipine was maintained for 4 additional weeks. Propranolol was added for "symptomatic" tachycardia. Nitrendipine reduced BP in 90% of patients completing all phases of the study (n = 49). The proportion of responders was 47% among the elderly and 44% among young subjects. Change in heart rate was similar in both groups (-0.1 +/- 9.9 and +2.9 +/- 8.8 beats/min, mean +/- standard deviation). Two elderly and 1 younger subject required addition of propranolol (difference not significant). There was no correlation between the age of patients and changes in supine systolic and diastolic BP or heart rate (r = 0.21, -0.15 and -0.21, respectively). Adverse effects occurred with equal frequency in older and younger subjects (19 of 21 vs 23 of 33 patients, difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Prophylactic mezlocillin in radical hysterectomy.

The role of prophylactic antibiotics in radical hysterectomy patients was studied in a double-blind randomized prospective study of mezlocillin (Mezlin, Miles Pharmaceuticals), a broad-spectrum semisynthetic penicillin, compared to placebo. Thirty evaluable patients received 4 g mezlocillin or saline placebo intravenously one-half hour before surgery, a second dose four to six hours later, and a final dose six hours after that. The rate of wound infection, postoperative use of additional antibiotics, fever index, and the incidence of standard febrile morbidity were all significantly lower in the mezlocillin group. Short-term perioperative prophylactic antibiotics are indicated in patients undergoing radical hysterectomy.

Evaluation of Duogastrome (carbenoxolone sodium) for the treatment of duodenal ulcer: a multicentre study.

A double-blind study was carried out in 152 Canadian patients, 76 given Duogastrone (carbenoxolone sodium) capsules, 50 mg qid, and 76 given placebo capsules qid for 6 weeks. All patients had a duodenal ulcer diagnosed by roentgenography or endoscopy, or both. Evaluation of the efficacy of Duogastrone therapy was based on data from the 119 patients (59 treated with Duogastrone and 60 with placebo) who met all the strict requirements of the protocol. The ulcers healed completely in 75% (44/59) of the patients treated with Duogastrone and in 48% (29/60) of those treated with placebo; this difference is significant (P less than 0.01). The proportions were similar in the patients assessed only endoscopically: 76% (32/42) and 55% (26/47), respectively. In the group treated with Duogastrone the following side effects were noted: weight gain, edema, mild hypokalemia, increase in blood pressure and slight increases in serum concentrations of lactic dehydrogenase and alkaline phosphatase. None was serious. However, close clinical monitoring by weekly visits to their physician is recommended for every patient undergoing Duogastrone therapy, at least during the 1st month.