Drugs Five Years Later

Data, Joann L.; Nies, Alan S.

doi:10.7326/0003-4819-81-4-500

Cited by 42 publications

(9 citation statements)

References 34 publications

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“…In contrast to protamine-treated animals we observed only slight congestion of the lungs after administration of Dex40-GTMAC3. We found one report of noncardiogenic pulmonary edema in previously healthy patient receiving dextran 40 kDa (Kaplan and Sabin, 1975 ), but such pulmonary capillary leakage and subsequent pulmonary edema were not included among the adverse reactions of dextran 40 kDa (Data and Sies, 1974 ).…”

Section: Discussionmentioning

confidence: 99%

The Toxicokinetic Profile of Dex40-GTMAC3—a Novel Polysaccharide Candidate for Reversal of Unfractionated Heparin

et al. 2016

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Though protamine sulfate is the only approved antidote of unfractionated heparin (UFH), yet may produce life threatening side effects such as systemic hypotension, catastrophic pulmonary vasoconstriction or allergic reactions. We have described 40 kDa dextrans (Dex40) substituted with glycidyltrimethylammonium chloride (GTMAC) as effective, immunogenically and hemodynamically neutral inhibitors of UFH. The aim of the present study was to evaluate in mice and rats toxicokinetic profile of the most promising polymer—Dex40-GTMAC3. Polymer was rapidly eliminated with a half-time of 12.5 ± 3.0 min in Wistar rats, and was mainly distributed to the kidneys and liver in mice. The safety studies included the measurement of blood count and blood biochemistry, erythrocyte osmotic fragility and the evaluation of the histological alterations in kidneys, liver and lungs of mice and rats in acute and chronic experiments. We found that Dex40-GTMAC3 is not only effective but also very well tolerated. Additionally, we found that protamine may cause overt hemolysis with appearance of permanent changes in the liver and kidneys. In summary, fast renal clearance behavior and generally low tissue accumulation of Dex40-GTMAC3 is likely to contribute to its superior to protamine biocompatibility. Intravenous administration of therapeutic doses to living animals does not result in the immunogenic, hemodynamic, blood, and organ toxicity. Dex40-GTMAC3 seems to be a promising effective and safe candidate for further clinical development as new UFH reversal agent.

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Section: Discussionmentioning

confidence: 99%

The Toxicokinetic Profile of Dex40-GTMAC3—a Novel Polysaccharide Candidate for Reversal of Unfractionated Heparin

et al. 2016

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“…However, dextran has been associated with nephrotoxicity and anaphylactoid reactions. 24,25 Thus, we believe that heparinized saline solution promises to be a superior agent for carotid OCT imaging. In rare instances of known heparin allergy, image acquisition could likely be achieved in a similar fashion with nonheparinized saline flush.…”

Section: Discussionmentioning

confidence: 99%

Frequency-Domain Optical Coherence Tomography Assessment of Human Carotid Atherosclerosis Using Saline Flush for Blood Clearance without Balloon Occlusion

Given

Attizzani

Jones

et al. 2013

AJNR Am J Neuroradiol

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SUMMARY FD-OCT is a new imaging technique that allows unprecedented in vivo microlevel assessment of human carotid plaque morphologic patterns and stent-vessel interactions. Prior reports describing the use of this technique have used balloon occlusion of the target vessel or iodinated contrast media to facilitate imaging. We report, for the first time, in vivo FD-OCT imaging of human carotid arteries without the use of iodinated contrast material or balloon occlusion techniques. ABBREVIATIONS:FD ϭ frequency-domain; OCT ϭ optical coherence tomography; TD ϭ time-domain

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“…13 Reported complications associated with intravenous dextran solutions include allergic reactions, hypervolemia, renal insufficiency, and disseminated intravascular coagulopathy!·"·" Our patient was treated in the ICU without central venous or pulmonary artery cannulation. The high molecular weight and colloid osmotic pressure effects of dextran preparations account for both their efficacy and many of the side effects.…”

Section: Discussionmentioning

confidence: 99%