No abstract

Patients with asthma presenting to the accident and emergency department at Southampton General Hospital during 12 months were reviewed retrospectively to determine how many patients attended, when and how patients were assessed and treated, and what factors appeared to influence whether a patient was admitted to a medical ward or not. Thirty five visits were made by patients requesting a repeat prescription for a metered dose inhaler. A further 193 visits were made by 152 patients (93 male, 59 female); only data on the first visit of any individual were analysed in this study. Patients were more likely to visit in the autumn, at the weekend, and in the evenings. Observations and measurements used to assess the severity of asthma were recorded with variable frequency-heart rate in 84% of examinations, pulsus paradoxus in 13%, and peak flow rate in 11%. Blood pressure was five times more likely to be recorded than peak flow rate. The drugs used to treat asthma were, in order of frequency, a ,B agonist (120 patients), intravenous aminophylline (39), and intravenous corticosteroids (30). Sixty (39%) of the patients were admitted to a medical ward. Admission was more likely to occur when patients arrived during the week than at the weekend, when they had cyanosis or pulsus paradoxus, and after receiving parenteral treatment.

A randomized double-blind trial was carried out in an accident and emergency department to reassess mefenamic acid as a suitable alternative analgesic to the combination of dextropropoxyphene plus paracetamol. Analysis of data from 87 patients showed that mefenamic acid was equally effective in relieving pain and was less likely to produce adverse side-effects.

No abstract

The effect of ethamivan (vanillic acid diethylamide) on the ventilatory response to carbon dioxide has been investigated in healthy young adult males. Intravenous infusion of the drug at a rate of 9 mg/min causes respiratory stimulation depending in degree upon the prevailing alveolar CO2 tension. When the latter is low stimulation by the drug is most marked and may largely support respiration below the CO, threshold. As alveolar Pco2 increases, the effect of the drug disappears. These findings are discussed.