Prehospital resuscitation and sudden cardiac death

Rates of survival horn pre-hospital cardiac arrest are often used to judge the quality of emergency medical systems. Despite many advances in technology and pharmacotherapy over the last two decades, overall survival rates in most systems remain disappointing. Objective analysis of different systems of care and associated outcomes has been hampered by a lack of uniform data reporting. Attempts to improve survival must focus on the key to resuscitation from sudden cardiac death, that is rapid response defibrillation.     

Experimental Studies on Reproduction with the Lipid-Regulating Agent Gemfibrozil

Experimental Studies on Reproduction with the Lipid-RegulatingAgent Gemfibrozil. FITZGERALD, J. E., PETRERE, J. A., AND DELA IGLESIA, F. A. (1987). Fundam. Appl. Toxicol. 8, 454–464.Gemfibrozil, a new lipid-regulating agent, was evaluated inrats and rabbits for effects on various phases of the reproductionprocess. In teratology studies groups of pregnant rats and rabbitsreceived gemfibrozil at doses up to 200 mg/kg during organogenesis(rat, Days 6–15; rabbit, days 6–18). For peri- andpostnatal studies, groups of pregnant rats were given 92 or3 31 mg/kg from Day 15 of gestation through weaning. In fertilitystudies groups of sexually mature male rats were given 93 or326 mg/kg of gemfibrozil for 61 days and females were given94 or 318 mg/kg for 15 days prior to mating within treatmentgroups. Drug administration continued in females through gestationand weaning of the F₁ offspring. In subsequent fertility experiments,treated male rats were mated with untreated females and treatedfemales were cohabitated with untreated males. Gemfibrozil didnot elicit a teratogenic response in either rats or rabbitsup to doses that resulted in maternal toxicity. Reduced pupweights during the neonatal and weaning periods in the femalefertility study as well as in the perinatal–postnatalstudy were the only apparent drug effect. Treatment of femalerats prior to mating had no significant effects on general reproductiveparameters. Male rats given doses of about 300 mg/kg/day showedinconsistent and equivocal lower rates of fertility relativeto the concurrent controls. No adverse effects were seen inthe reproductive performance of offspring of gemfibrozil-treatedmale rats.     

Studies on Reproduction in Rats with Meclofenamate Sodium, a Nonsteroidal Anti-inflammatory Agent

Studies on Reproduction in Rats with Meclofenamate Sodium, aNonsteroidal Anti-inflammatory Agent. PETRERE, J. A., HUMPHREY,R. R., ANDERSON, J. A., FITZGERALD, J. E., AND DE LA IGLESIA,F. A. (1985). Fundam. Appl. Toxicol. 5, 665–671. Reproductionand teratology studies were performed in rats given meclofenamatesodium, a nonsteroidal anti-inflammatory agent. Dosages of 0,3, 6, and 9 mg/kg were administered orally as dietary admixturesin the Fertility and Perinatal-Postnatal studies. In the Teratologystudy, dosages of 10, 12, 15, and 20 mg/kg were administeredby intragastric intubation. In the Male-Fertility study no adverseeffects on fertility or litter and offspring parameters wereobserved in two generations. In the Female-Fertility and Perinatal-Postnatalstudies, maternal toxicity (death associated with intestinalulceration and adhesions) was particularly evident during lactation.Prolonged gestation periods, decreased weanling weights, andincreased weanling mortality were evident at dosages of 6 and9 mg/kg. Increased postimplantation loss occurred at 6 and 9mg/kg in the Term Sacrifice subgroup of the Female-Fertilitystudy. Fertility rates were unaffected and all other litterand offspring parameters of the F₁ and F₂ generations appearednormal. In the Teratology study no adverse effects on embryonicor fetal development were evident at maternally toxic dosagesup to 20 mg/kg. © 1985 Society of Texicology.     

Treatment of a Patient with an Adenosine-Sensitive Ventricular Tachycardia Using Digoxin

Digitalis and Ventricular Tachycardia. Digoxin was used to treat a patient with an adenosine-sensitive ventricular arrhythmia. The patient had an exercise-induced ventricular tachycardia that was evaluated electrophysiologically and displayed characteristics of a triggered arrhythmia. The tachycardia was terminated reproducibly with 12 mg of intravenous adenosine. After treatment with digoxin (serum level = 1.7 ng/mL), the arrhythmia could no longer be initiated with programmed electrical stimulation or exercise treadmill testing. The patient has since remained symptom free for 10 months. The autonomic effects of digitalis are proposed to mediate drug efficacy in this form of ventricular tachycardia.