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LECTURE NOTES ON RESPIRATORY DISEASE
CODceDuate OD theophyUiDe therapy
So.""lay"'.@Oral Uq.'d (aminophylline, Fisons)
DESCRIPTION: Each 5 ml (teaspoonful)contains aminophylline105 mg (equivalentto 90 mg theophyllinebase) in a palatable base. Each 15 ml (tablespoonful)contains aminophylline 315 mg (equivalentto 270 mg theophylline base): NONALCOHOLIC SUGAR-FREE AcnONS: The prindpal pharmacologicalactions of aminophyllineare to relaxsmooth muscle, notably bronchial muscle,stimulatethe central nervous system, act on the kidneyto produce diuresis,and to stimulatecardiac muscle. INDICAUONS: For the symptomaticreliefof bronchialasthma, pulmonary emphysema, chronic bronchitisand other pulmonary diseases with bronchospasm. CONT8AINDICAUONS: SomophyUlne Oral Uquid (amlnophyl1lne) is contraindicatedin those patients who have shown hypersensitivity to itor to other theophyllinederivatives. WAIININGS AND PRECAUTIONS: Use with caution Inthe presence of severe hypertension. and In infantsand young chlJdren. Other formulations containingtheophyllineor itsderivativesshould not be administered concomitandy.Metabolismof aminophyllinemay be Impaired(leadingto the possibility of toxicblood levelson flx~d dosage regimens) in patients with severe pulmonary or cardiovasculardisease; or associated liver dysfunction. NOTE: The metabolismof theophylline is a major factorInthe observed interpatientserum level variability. Ideally,all Individuals should have serum theophyllinelevelsmeasured and a theophylline half-life calculatedwhichwould enable doses and dosing regimensto be tailoredto each patient to maintain a therapeutic level,and insure optimal clinical response and avoid tOxidty. ADVEllSE IlEAcnONS: Toxidty of theophyllineand Itsderivatives(e.g., aminophylline)may manifest as nausea. vomiting,peripheral vascular collapse, reactivationof peptic ulcers,Intestinal bleeding, albuminuria, palpitation,nervousness, and Insomnia. DOSAGE AND ADJllNlSTllAUON: Severe BronchospasticAttack:Adults;Four or ftveteaspoonfuls. Children; over the age of four years, the Initial dose.of1 teaspoonful per 40 pounds (18 kg.) of body weight is recommended. Dosage can be Increased'1 mg./2.2Ibs./dose (1 mg./1 kg./dose) each week depending upon clinicaIimprovemenl ChlJdrenunder 4 years of age, dosage at the directionof physician;lowerlnitialdosages (mg./kg.) may be required. (Preferably take dosage priorto meals witha glass of water.) JlAlNTENANCE 24-80011 THERAPY: Adults; two or three teaspoonfuls before breakfastand to be repeated at six (6) hour intervalsas required. Dosage should be adjusted to reflecttherapeutic serum levelsof approximately 10 IJ.g./ml. Children over the age of four, the recommended Initial dose is between 2.3 and 2.7 mg./lb. (5 and 6 mg./kg.)and is reflectedin the table below.
~ W~t
Pounds
Kilograms
r:=:ryIBa:.e In mg.
Oral ~. (af!'lnophyllne) InTeaspoonfuls
40
18
90 mg.
1 teaspoonful
60 79
27 36
135 mg. 180 mg.
1~ teaspoonfuls 2 teaspoonfuls
108
49
270 mg.
3 teaspoonfuls
HOW SUPPUED: Bottlesof 8 ft. oz. NOC 10585-1218-80 CAUDON: Federal law prohibitsdisp£nsing without prescription.0Asons Corporation '76 All RightsReserved.
Two Preston Court, Bedford, Mass. 01730
28
THE BOOKSHELF LECTURE NOTES ON RESPIRATORY DISEASE. By R. A. L. BREWIS. Oxford, England, Blackwell Scientific Publications, and Philadelphia, J. B. Lippincott Co., 1975, 241 pp, 74 ilIus, $13.00. This little paperback of slightly over 200 pages would not be the subject of review were it not for the fact that it serves a very practical function in today's medical milieu of self-assessment, recertification, and peer-review examinations. Here in these few pages in crisp and superb conciseness is a summary of the entire field of respiratory diseases. Obviously, much has been omitted. But the amount that Brewis has been able to include, especially in the very refreshing and original diagrammatic summaries, is evidence of a very experienced and skillful teacher. The emphasis throughout is on information which is useful and relevant to everyday clinical medicine. For example, in reviewing pulmonary physiology and the assessment of pulmonary function, all unnecessary complexities, symbols, and equations have been avoided; and attention has been focused on concepts and investigations which are in everyday use. The author presents his material with the express purpose of offering the medical student an alternative to attending lectures, the board candidate with his basic minimum requirements in the respiratory field, and the more mature general medical reader with a painless refresher course. We might add to these the teacher of pulmonary diseases who is looking for an excellent framework for his own presentations. Theodore H. Noehren, M.D., F.C.C.P. Salt Lake City
SURGICAL TREATMENT OF CONGENITAL HEART DISEASE (2nd ed). By GRADY L. ·HALLMAN and DENTON A. COOLEY. Philadelphia, Lea and Febiger, 1975,204 pp, $18.50. This edition consists of 204 pages compiled in essentially the same format as the first edition dealing with the surgical care of patients with congenital heart disease; however, this edition does include the surgical treabnent of additional anomalies not included in the first edition. These include the surgical management of cor triatriatum, parachute mitral valves, the scimitar syndrome, congenital coronary abnormalities, and the use of porcine heterograft conduits for reconstruction of the right ventricular
So.""lay"'.@Oral Uq.'d (aminophylline, Fisons)
DESCRIPTION: Each 5 ml (teaspoonful)contains aminophylline105 mg (equivalentto 90 mg theophyllinebase) in a palatable base. Each 15 ml (tablespoonful)contains aminophylline 315 mg (equivalentto 270 mg theophylline base): NONALCOHOLIC SUGAR-FREE AcnONS: The prindpal pharmacologicalactions of aminophyllineare to relaxsmooth muscle, notably bronchial muscle,stimulatethe central nervous system, act on the kidneyto produce diuresis,and to stimulatecardiac muscle. INDICAUONS: For the symptomaticreliefof bronchialasthma, pulmonary emphysema, chronic bronchitisand other pulmonary diseases with bronchospasm. CONT8AINDICAUONS: SomophyUlne Oral Uquid (amlnophyl1lne) is contraindicatedin those patients who have shown hypersensitivity to itor to other theophyllinederivatives. WAIININGS AND PRECAUTIONS: Use with caution Inthe presence of severe hypertension. and In infantsand young chlJdren. Other formulations containingtheophyllineor itsderivativesshould not be administered concomitandy.Metabolismof aminophyllinemay be Impaired(leadingto the possibility of toxicblood levelson flx~d dosage regimens) in patients with severe pulmonary or cardiovasculardisease; or associated liver dysfunction. NOTE: The metabolismof theophylline is a major factorInthe observed interpatientserum level variability. Ideally,all Individuals should have serum theophyllinelevelsmeasured and a theophylline half-life calculatedwhichwould enable doses and dosing regimensto be tailoredto each patient to maintain a therapeutic level,and insure optimal clinical response and avoid tOxidty. ADVEllSE IlEAcnONS: Toxidty of theophyllineand Itsderivatives(e.g., aminophylline)may manifest as nausea. vomiting,peripheral vascular collapse, reactivationof peptic ulcers,Intestinal bleeding, albuminuria, palpitation,nervousness, and Insomnia. DOSAGE AND ADJllNlSTllAUON: Severe BronchospasticAttack:Adults;Four or ftveteaspoonfuls. Children; over the age of four years, the Initial dose.of1 teaspoonful per 40 pounds (18 kg.) of body weight is recommended. Dosage can be Increased'1 mg./2.2Ibs./dose (1 mg./1 kg./dose) each week depending upon clinicaIimprovemenl ChlJdrenunder 4 years of age, dosage at the directionof physician;lowerlnitialdosages (mg./kg.) may be required. (Preferably take dosage priorto meals witha glass of water.) JlAlNTENANCE 24-80011 THERAPY: Adults; two or three teaspoonfuls before breakfastand to be repeated at six (6) hour intervalsas required. Dosage should be adjusted to reflecttherapeutic serum levelsof approximately 10 IJ.g./ml. Children over the age of four, the recommended Initial dose is between 2.3 and 2.7 mg./lb. (5 and 6 mg./kg.)and is reflectedin the table below.
~ W~t
Pounds
Kilograms
r:=:ryIBa:.e In mg.
Oral ~. (af!'lnophyllne) InTeaspoonfuls
40
18
90 mg.
1 teaspoonful
60 79
27 36
135 mg. 180 mg.
1~ teaspoonfuls 2 teaspoonfuls
108
49
270 mg.
3 teaspoonfuls
HOW SUPPUED: Bottlesof 8 ft. oz. NOC 10585-1218-80 CAUDON: Federal law prohibitsdisp£nsing without prescription.0Asons Corporation '76 All RightsReserved.
Two Preston Court, Bedford, Mass. 01730
28
THE BOOKSHELF LECTURE NOTES ON RESPIRATORY DISEASE. By R. A. L. BREWIS. Oxford, England, Blackwell Scientific Publications, and Philadelphia, J. B. Lippincott Co., 1975, 241 pp, 74 ilIus, $13.00. This little paperback of slightly over 200 pages would not be the subject of review were it not for the fact that it serves a very practical function in today's medical milieu of self-assessment, recertification, and peer-review examinations. Here in these few pages in crisp and superb conciseness is a summary of the entire field of respiratory diseases. Obviously, much has been omitted. But the amount that Brewis has been able to include, especially in the very refreshing and original diagrammatic summaries, is evidence of a very experienced and skillful teacher. The emphasis throughout is on information which is useful and relevant to everyday clinical medicine. For example, in reviewing pulmonary physiology and the assessment of pulmonary function, all unnecessary complexities, symbols, and equations have been avoided; and attention has been focused on concepts and investigations which are in everyday use. The author presents his material with the express purpose of offering the medical student an alternative to attending lectures, the board candidate with his basic minimum requirements in the respiratory field, and the more mature general medical reader with a painless refresher course. We might add to these the teacher of pulmonary diseases who is looking for an excellent framework for his own presentations. Theodore H. Noehren, M.D., F.C.C.P. Salt Lake City
SURGICAL TREATMENT OF CONGENITAL HEART DISEASE (2nd ed). By GRADY L. ·HALLMAN and DENTON A. COOLEY. Philadelphia, Lea and Febiger, 1975,204 pp, $18.50. This edition consists of 204 pages compiled in essentially the same format as the first edition dealing with the surgical care of patients with congenital heart disease; however, this edition does include the surgical treabnent of additional anomalies not included in the first edition. These include the surgical management of cor triatriatum, parachute mitral valves, the scimitar syndrome, congenital coronary abnormalities, and the use of porcine heterograft conduits for reconstruction of the right ventricular