Effect of prolonged oral terbutaline therapy on glucose tolerance in pregnancy.

OBJECTIVE: Our objective was to elucidate the pathophysiologic effects and potential reversibility of terbutaline-induced changes in carbohydrate metabolism. STUDY DESIGN: We prospectively evaluated serum glucose, insulin, glucagon, C-peptide, and pancreatic polypeptide levels in response to a 100 gm glucose challenge (oral 3-hour glucose tolerance test) in 17 obstetric patients without complications who were given terbutaline (5 mg orally every 4 hours) for 5 consecutive days between 24 and 32 weeks' gestation. Each patient served as her own control, with day 1 representing pretreatment, day 7 the treatment phase, and day 14 the posttreatment evaluation. Body mass index and posttreatment serum terbutaline levels were also measured. RESULTS: A significant initial treatment effect (day 1 versus 7) was observed for glucose (elevated), insulin (elevated), insulin/glucose ratio (elevated), and pancreatic polypeptide (elevated). A significant delayed treatment effect (day 1 versus 14) was also observed for insulin (elevated), insulin/glucose ratio (elevated), and pancreatic polypeptide (elevated). Body mass index directly correlated with postchallenge measures of insulin, insulin/glucose ratio, pancreatic polypeptide, and C-peptide. Posttreatment serum terbutaline levels directly correlated with pancreatic polypeptide, but not with other parameters. CONCLUSIONS: Our data support a dose-independent, terbutaline-induced glucose intolerance mediated by glucagon and caused by diminished insulin sensitivity.

Use of selected freshwater bivalves for monitoring organochlorine pesticide residues in major Mississippi stream systems, 1972-73.

Seven species of freshwater Pelecypoda, Amblema costata, Corbicula manilensis, Elliptio crassidens, lampsilis anadontoides, Lampsilis claibornensis, Megalonaias gigantea, and Plectomerus dombeyanus, were collected and monitored for pesticide content during 1972 and 1973. Thirteen collection sites, representing five major river basins in the state of Mississippi, were sampled and compared. During the 24-month study, 26 water samples and 58 claim samples from the five river basins were analyzed. Individual samples weighed from 8 g to 20 g and consisted of 1-30 clams, depending on size. Residues of toxaphene and methyl parathion were found only in 1973 water samples. The study shows that freshwater clams are effective monitors of pesticide content. The tendency of clams to concentrate pesticides and their corresponding ability to eliminate them varies with species. Significant reductions in DDT and a corresponding buildup of p,p'-TDE were noted in 1973, following the limitations on the use of DDT and large-scale flooding throughout the state.

Synthesis and local anesthetic properties of secondary alkoxyalkylaminoacylanilides.

Nineteen secondary alkoxyalkylaminoacylanilides were prepared. They were weaker bases and were more hydrophilic than the corresponding analogs lacking the ether function. In 2% solution, these compounds blocked the rat sciatic nerve in vivo after relatively short onset times with good frequency of anesthesia. The duration of block was 0.4--1.5 times that of lidocaine. Their systemic toxicity was low, and their irritation liability in most instances was acceptable.