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Aim: To evaluate the efficacy and safety of a combination drug containing ambroxol, guaifenesin, and levosalbutamol, oral solution, versus Ascoril Expectorant, syrup (combination of bromhexine, guaifenesin, and salbutamol) in the treatment of productive cough in adult patients with acute bronchitis., Materials and Methods: This open-label, randomized, phase III study included patients with acute bronchitis who had a productive cough with difficulty in sputum expectoration. 244 patients were randomized in a 1:1 ratio and received 10 mL of the study drug or reference drug 3 times daily for 2 weeks. After 7 and 14 days of treatment, the physician evaluated patient's subjective complaints and the efficacy of therapy. The primary endpoint was the proportion of patients with high and very high efficacy., Results: The primary endpoint was reached by 70 (0.5738) patients in the study drug group and 54 (0.4426) in the reference drug group ( p =0.04). The intergroup difference was 0.1311 [95% confidence interval: 0.0057; 0.2566]. The lower limit of the 95% confidence interval was above zero, which confirms the superiority of therapy with the study drug over therapy with Ascoril Expectorant. The proportion of patients with a 1-point total score reduction and with complete resolution of all symptoms according to the Modified Cough Relief and Sputum Expectoration Questionnaire after 7 and 14 days was numerically higher in the study drug group versus the reference drug group. There were no statistically significant differences between the groups in the incidence of adverse events., Conclusion: The efficacy of a new combination drug containing ambroxol, guaifenesin, and levosalbutamol in the treatment of productive cough in adult patients with acute bronchitis is superior to the efficacy of Ascoril Expectorant. The safety profiles of the study drug and the reference drug were comparable.

Combinatorial drug therapy has attracted substantial attention as an emerging strategy for the treatment of diseases with complex pathological mechanisms. We previously developed a potentially universal computational screening approach for combination drugs and used this approach to successfully identify some beneficial combinations for the treatment of heart failure. Herein, this screening approach was used to identify novel combination drugs for the treatment of epilepsy in an approved drug library. The combination of guaifenesin-andrographolide was first discovered as a promising therapy with synergistic anticonvulsant activities in maximal electroshock (MES)- and subcutaneous pentylenetetrazol (sc-PTZ)-induced epilepsy models in vivo. The studies of network analysis, fluorescence imaging, and N -methyl-d-aspartate (NMDA)-induced cytotoxicity further revealed that guaifenesin-andrographolide might synergistically affect NMDA receptors and then alleviate the pathogenesis of epilepsy. Therefore, we report that the combination of guaifenesin-andrographolide exerts effects against epilepsy through a novel synergistic mechanism and is thus a potential treatment for epilepsy, providing a promising mechanism for the design of novel combinatorial drug treatments against epilepsy.

Objective: This exploratory study assessed the safety of the combination of sulfamethoxazole, trimethoprim and guaifenesin (STG) in adult and pediatric patients with acute bronchitis according to local labelling in Peru., Results: We enrolled 51 pediatric and 52 adult participants diagnosed with acute bronchitis and indication of STG. The mean ages were 7.6 years (SD ± 3.2 years) and 42.8 years (SD ± 16.1) and the proportion of female patients were 51% and 65%, respectively. The duration of treatment in pediatric patients was < 5 days in 2% of patients, 5 days in 13.7%, 6-7 days, in 82.4% and > 7 days in 2% while in adults patients it was < 5 days in 17%, 5 days in 69.2%; 6-7 days in 28.8% of patients. Adverse events (AEs) were registered in 9.6% and 19.2% of pediatric and adult patients, respectively. These AEs had definite relation of causality with the study drugs in 2 adults (20% of AEs) and possible causality with the study drugs in 4 pediatric (80% of AEs) and 2 adult cases (20% of AEs). Our results provide valuable data to develop trials of pharmacovigilance where different statistical parameters should be considered to calculate an adequate sample size in studies evaluating STG in pediatric or adult patients. Trial registration NCT02879981 and NCT02902640.

Drug-related kidney stones are a diagnostic problem, since they contain a large matrix (protein) fraction and are frequently incorrectly identified as matrix stones. A urine proteomics study patient produced a guaifenesin stone during her participation, allowing us to both correctly diagnose her disease and identify proteins critical to this drug stone-forming process. The patient provided three random midday urine samples for proteomics studies; one of which contained stone-like sediment with two distinct fractions. These solids were characterized with optical microscopy and Fourier transform infrared spectroscopy. Immunoblotting and quantitative mass spectrometry were used to quantitatively identify the proteins in urine and stone matrix. Infrared spectroscopy showed that the sediment was 60 % protein and 40 % guaifenesin and its metabolite guaiacol. Of the 156 distinct proteins identified in the proteomic studies, 49 were identified in the two stone-components with approximately 50 % of those proteins also found in this patient's urine. Many proteins observed in this drug-related stone have also been reported in proteomic matrix studies of uric acid and calcium containing stones. More importantly, nine proteins were highly enriched and highly abundant in the stone matrix and 8 were reciprocally depleted in urine, suggesting a critical role for these proteins in guaifenesin stone formation. Accurate stone analysis is critical to proper diagnosis and treatment of kidney stones. Many matrix proteins were common to all stone types, but likely not related to disease mechanism. This protocol defined a small set of proteins that were likely critical to guaifenesin stone formation based on their high enrichment and high abundance in stone matrix, and it should be applied to all stone types.

Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one-time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects' ability to drive was assessed by their performance in a driving simulator (STISIM® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1-h postdrug administration. The one-time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior., (© 2015 American Academy of Forensic Sciences.)

Background: Guaifenesin is a common nonprescription medication that has been implicated in drug-induced nephrolithiasis. Dextromethorphan, a nonprescription antitussive found in some guaifenesin-containing preparations, is increasingly recognized as a substance of abuse by many youth and young adults. Renally excreted medications known to have poor solubility in urine have the potential to precipitate when ingested in large quantity, leading to acute obstruction of the ureters and renal failure., Objective: We describe the case of a 22-year-old male who developed severe bilateral flank pain, hematuria, and oliguria after an isolated recreational ingestion of guaifenesin and dextromethorphan., Case Report: The patient was found to have bilateral ureteral obstruction and acute renal failure, suspected to be secondary to precipitation of medication metabolites in the urine., Conclusions: This case highlights the potential for acute renal failure secondary to guaifenesin and dextromethorphan abuse., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Several medications or their metabolites have been associated with urolithiasis, although overall they remain an infrequent cause of urolithiasis. Guaifenesin stones were originally reported as complexed with ephedrine, and subsequent reports have demonstrated pure guaifenesin stones, occurring after long term abuse. We report a case of a 23-year-old male who ingested a large, one time dose of guaifenesin, resulting in acute bilateral ureteral obstruction, which, to our knowledge, is the first such reported case in the literature.

This paper reports results of international multicentre non-interventional clinical study of the effectiveness and safety of ascoril expectorant for the treatment of cough in Kazakhstan and Uzbekistan. The study included 16312 patients examined in different cities during 2011-2012. It showed that ascoril expectorant (Glenmark) at a standard dose is an effective agent for the treatment of cough in children above 3 years and adults aged up to 78 years with ARVI and acute bronchitis, exacerbation of these conditions or grade I-II chronic obstructire pulmonary disease. Most patients reported good therapeutic effect within 1 day after intake. Ascoril expectorant caused no adverse reactions and was well tolerated by the patients. 91% of the attending physicians describe the drug as highly effective.

Seven Thoroughbred horses were castrated under total intravenous anesthesia (TIVA) using propofol and medetomidine. After premedication with medetomidine (5.0 µg/kg, intravenously), anesthesia was induced with guaifenesin (100 mg/kg, intravenously) and propofol (3.0 mg/kg, intravenously) and maintained with constant rate infusions of medetomidine (0.05 µg/kg/min) and propofol (0.1 mg/kg/min). Quality of induction was judged excellent to good. Three horses showed insufficient anesthesia and received additional anesthetic. Arterial blood pressure changed within an acceptable range in all horses. Decreases in respiratory rate and hypercapnia were observed in all horses. Three horses showed apnea within a short period of time. Recovery from anesthesia was calm and smooth in all horses. The TIVA-regimen used in this study provides clinically effective anesthesia for castration in horses. However, assisted ventilation should be considered to minimize respiratory depression.

Objective: To describe the pharmacology and safety of oral over-the-counter cough suppressants and expectorants and to present recommendations for the use of these agents in solid-organ transplant recipients based on the potential for adverse drug reactions or drug-disease interactions., Data Sources and Extraction: Data from journal articles and other sources describing the pharmacology and safety of over-the-counter cough suppressants and expectorants, drug-drug interactions with immunosuppressive agents, and drug-disease state interactions are reviewed., Data Synthesis: Potential and documented drug-drug interactions between immunosuppressive agents and over-the-counter cough medications guaifenesin, dextromethorphan, diphenhydramine, and codeine were evaluated on the basis of pharmacokinetic and pharmacodynamic principles. Interactions between these cough medications and the physiological changes in the body following transplantation also were examined., Conclusion: Diphenhydramine requires additional monitoring when used to treat cough in transplant recipients owing to its anticholinergic properties and the potential for interactions with cyclosporine. Dextromethorphan can be used in most transplant recipients, although greater caution should be exercised if the patient has undergone liver transplant or has liver impairment. Guaifenesin can be used in transplant recipients but should be used with caution in patients receiving kidney or lung transplants and in patients with renal impairment. Codeine combined with guaifenesin is another option for cough and can be used in most transplant patients although those with reduced renal function should be monitored carefully for adverse events.

Objective: To evaluate efficacy and safety of Guaifenesin compound pseudoephedrine hydrochloride oral solution for the treatment of cough, expectoration, nasal congestion and runny nose in children., Method: This was a prospective multicenter randomized single-blind, parallel-controlled clinical study. A total of 10 centers participated in this study, the actual number of cases in line with the program was 412, of whom 205 cases in trial group were treated with Guaifenesin compound pseudoephedrine hydrochloride oral solution, and 207 cases in control group with ambroxol hydrochloride oral solution, treatment of both groups persisted for 7 days. The improvement rate of each single symptom and the combined symptoms and the overall effective rate were compared between the two groups. The adverse drug reactions and compliance were assessed as well., Result: The treatment of both groups showed efficacy. Except sputum stickiness, the improvement of all symptoms in trial group was superior to that in the control group on the 3rd day after treatment (P < 0.05) and except nasal congestion, the efficacy in all the other symptoms of trial group was better than that in the control group as well on the 7th day (P < 0.01). The improvement rate for combined symptoms of Guaifenesin compound pseudoephedrine hydrochloride oral solution was 82.9% and the overall efficacy rate was 89.3%. Guaifenesin compound Pseudoephedrine hydrochloride oral solution had higher compliance and its adverse event rate was merely 0.92%., Conclusion: Guaifenesin compound pseudoephedrine hydrochloride oral solution showed significant efficacy and safety in children for treatment of cough, expectoration, nasal congestion and runny nose caused by common cold or acute tracheobronchitis.

Adverse drug reactions lead to a significant number of hospital admissions each year and thus contribute to the overall financial burden of health care. Some of these drug reactions are allergic responses. As the overall predictability of allergic responses to drugs remains low, efforts to improve our understanding of the processes underlying these responses continue as we strive toward the ultimate goal of primary prevention. Allergic reactions range from mild pruritic to severe systemic anaphylactic responses. We report a case of a young healthy man who developed an anaphylactic reaction to an over-the-counter expectorant. A skin test showed that the patient had an immunoglobulin E-mediated allergic response to guaifenesin, one of the components of commonly available cough medications. Our review of published literature showed that this is the first report of a severe allergic response to guaifenesin.

Guaifenesin is a commonly used expectorant whose use may lead to the occasional formation of guaifenesin urinary stones. We herein describe a patient who was taking 2400 mg Guaifenesin per day as part of his treatment for asthma. He had a past history of a guaifenesin stone removed ureteroscopically. His current presentation was with a 9 mm by 6 mm stone in the upper left ureter, seen on CT scan, and treated initially with a ureteral stent and hydration. After 3 weeks, the stone had disappeared, as confirmed by repeat CT scan. The genesis and treatment of guaifenesin stones is discussed.

Objectives: Ephedrine and guaifenesin are herbal supplements that have experienced increased use over the past decade. Ephedrine has been used as a stimulant and weight-loss product, guaifenesin as an expectorant and cough suppressant; both are found in combination in many antitussives and expectorants. This paper reviews the reported cases of ephedrine- and guaifenesin-induced nephrolithiasis, as well as the diagnostic techniques and treatments that have been successfully used for these stones., Design: A systematic review of the literature pertaining to nephrolithiasis and the compounds ephedrine and guaifenesin was conducted., Results: Ephedrine and guaifenesin use results in over 35% of urinary stones that are related to pharmaceutical metabolites, and collectively are present in 0.1% of all urinary stones. These calculi are radiolucent, requiring the use of computerized tomography (CT scan) for diagnosis. Alkalinization therapy offers an alternative to surgical intervention and may have a role in prevention of recurrence., Conclusions: Ephedrine and guaifenesin have been shown to cause nephrolithiasis in cases of abuse when taken individually or in combination. It is important for the clinician to be aware of the potential for these compounds to cause nephrolithiasis.

We report on a patient with bilateral ureteral calculi composed of guaifenesin metabolite as determined by infrared spectroscopy. These stones may be associated with excessive guaifenesin intake related to the current popularity of ephedrine preparations.

A patient with a history of ingesting large quantities of an over-the-counter stimulant developed renal calculi that on further analysis, after stone passage, revealed increased amounts of ephedrine. Over the course of 7 months, all of the patient's ephedrine stones were managed successfully by alkalinization. Similar to previously reported ephedrine calculi, these stones were radiolucent on x-ray imaging, but their course was monitored on serial nonenhanced computed tomography scans. We believe this to be the first reported use of alkaline therapy for the dissolution of renal stones containing ephedrine.

A total of 768 patients were recruited by 81 physicians and paediatricians all over the country in this National Study Group of 'Ascoril + Expectorant'. The results of this first large scale study of a cough formula indicates that 'Ascoril + Expectorant' is effective in controlling cough, breathlessness and decreasing the volume of sputum. No serious adverse events were noted. Ascoril was well accepted by the patients and its efficacy was rated very high by the physician. The National Study Group concludes that 'Ascoril + Expectorant' is highly effective in the management of cough associated with lower respiratory tract infection and COPDs.

The present study was undertaken to study the comparative safety and efficacy of two cough formulas viz, Ascoril expectorant and other cough formula in the management of cough associated with respiratory disorders. Fifty patients having cough associated with various respiratory disorders like bronchitis and upper or lower respiratory tract infections were randomly divided into 2 equal groups and were treated with one of the two cough formulas viz, Ascoril cough formula and other cough formula in double-blind manner over a period of 15 days. The evaluation of improvement was carried out by a rating scale using three clinical parameters--cough, sputum and breathlessness. The physicians were asked to rate the effectiveness of the therapy and patients were asked to rate the acceptability of therapy using pre-defined operational criteria. It was observed that the improvement and symptom relief was almost immediate, quicker and better in the group receiving Ascoril as compared to other group. On effectiveness parameter, 96% of the physicians rated Ascoril as having either 'very high effectiveness or high effectiveness' as opposed to only 34% of the physicians who rated other cough formula as having 'high' or 'very high effectiveness'. While on parameter of acceptability, 96% of the patients rated acceptability of Ascoril as 'high' or 'good' as opposed to only 24% of the patients who rated other cough formula 'high' or 'good'. The findings of this study suggests that Ascoril cough formula has better efficacy as well as better patient acceptability. Thus, Ascoril cough formula is superior to other cough formula in management of cough associated with respiratory disorders.

Purpose: We report a new type of drug-induced stone that is caused by overconsumption of preparations containing guaifenesin and ephedrine., Materials and Methods: Clinical and stone analysis data from the Molecular Structure Laboratory at the Veterans Affairs Medical Center in Milwaukee, Wisconsin, were reviewed. Stone analysis was performed by Fourier transform infrared spectroscopy, high-resolution X-ray crystallographic powder diffraction, or both. The urine and stone material from one of the subjects were analyzed with high-performance liquid chromatography., Results: Stone analysis from seven patients demonstrated metabolites of guaifenesin. High-performance liquid chromatography revealed that the stone and urine from one subject had a high content of guaifenesin metabolites and a small amount of ephedrine. Demographic data were available on five patients. Three had a history of alcohol or drug dependency. All were consuming over-the-counter preparations containing ephedrine and guaifenesin. Four admitted to taking excessive quantities of these agents, mainly as a stimulant. Hypocitraturia was identified in two individuals subjected to urinary metabolic testing. These stones are radiolucent on standard X-ray imaging but can be demonstrated on unenhanced CT. Shockwave lithotripsy was performed in two patients, and the calculi fragmented easily., Conclusions: Individuals consuming large quantities of preparations containing ephedrine and guaifenesin may be at risk to develop stones derived mainly from metabolites of guaifenesin and small quantities of ephedrine. These patients may be prone to drug or alcohol dependency.

Objectives: Several urinary calculi were submitted to our institution for compositional analysis. The typical techniques of analysis, polarized light microscopy, electron microprobe analysis, and infrared spectroscopy proved inadequate for a definitive identification. As a result, a more detailed organic analysis was conducted to determine the exact chemical structure of the material., Methods: Infrared spectroscopy and mass spectrometric analysis were carried out on the solid material, providing information concerning the functional groups and the molecular mass of the organic constituent and its components. The stone was solubilized in deuterated solvents and analyzed by nuclear magnetic resonance spectroscopy, which resulted in a definitive chemical structure., Results: The spectroscopic analysis indicated that the stones were composed of a calcium salt of beta-(2-methoxyphenoxy)-lactic acid, a metabolite of the pharmaceutical guaifenesin, which is used as an expectorant., Conclusions: Guaifenesin, an expectorant common in over-the-counter cold and allergy remedies, can cause urolithiasis if taken in excess. Discussions with physicians and their patients confirmed that most patients admitted to taking large doses of guaifenesin-containing medications.

The Confidential Enquiry into Perioperative Equine Fatalities (CEPEF-1) is an observational multi-institutional prospective study of recovery outcome at 7 days post operatively, as called for by Steffey (1991). Data from 6,255 general anaesthetics (February 91-March 93) were submitted confidentially by 62 clinics. The outcomes of 333 cases which were subjected to euthanasia and which were not classified 'alive' or 'died' at 7 days, were excluded from the analysis. The remaining 5922 cases were analysed to identify risk ratios (RR) between survivors and nonsurvivors for a variety of factors. These preliminary results indicate an overall death rate, for equine patients dying or being subjected to euthanasia within 7 days of a general anaesthetic because of perioperative complications, of 102/6255 (1.6%). This mortality rate decreased to 46/5220 (0.9%) when all colic surgery and delivery of foals under general anaesthesia were excluded. There was an increased risk for mares in the last trimester of pregnancy (RR = 6.4). Patients undergoing emergency abdominal procedures (colic patients and pregnant mares undergoing controlled or caesarean section delivery of foals) under general anaesthesia were at increased risk (RR = 12.9) compared to ear, nose and throat surgery. Within orthopaedic surgery, patients requiring internal fixation were at increased risk (RR = 3.2) compared to those undergoing miscellaneous orthopaedic surgery. There was no difference in risk between breeds. Patients not placed in dorsal recumbency were at reduced risk (RR = 0.3-0.5) compared to those which were in dorsal recumbency.(ABSTRACT TRUNCATED AT 250 WORDS)

Background: Cough is one of the most common symptoms of respiratory infections for which patients seek relief. This study was done to assess the effectiveness of three commonly prescribed cough syrups., Methods: In this multipractice, office-based, randomized clinical trial, guaifenesin was compared with guaifenesin plus codeine or guaifenesin plus dextromethorphan in patients with uncomplicated respiratory tract infections. Family physicians enrolled 97 patients between February 1988 and April 1990. Patients were randomly assigned to treatment and were interviewed by telephone at 2, 4, and 10 days to assess cough relief, treatment adherence, and side effects. There were no statistically significant differences among treatment groups at base line., Results: At day 2 there were no statistically significant differences among treatment groups for any of the outcome measures. At day 4 five of the outcome measures of cough quality, frequency, sleep disturbances, and absenteeism were not statistically significantly different among groups. The only statistically significant difference was the ability to keep up with usual activities, which improved least in patients assigned to dextromethorphan than in patients in other groups. There were no statistically significant differences among the three groups at day 10 for any of the outcomes., Conclusion: It appears that codeine, dextromethorphan, and guaifenesin are equally effective in relieving cough symptoms.

Twelve horses of various breeds and either sex were anesthetized with xylazine and ketamine injected into a median or lateral thoracic vein. During anesthesia, with the horse in sternal recumbency, a 14-gauge, 8.9 cm catheter was inserted into each jugular vein by using aseptic technique. Guaifenesin in water (100 mg/kg or a maximum dose of 50 grams) was infused into one jugular vein and an equal volume of 0.9% saline solution was infused into the other jugular vein. Seven horses received 10% guaifenesin, and five horses received 5% guaifenesin. The catheters were removed before the horses recovered from anesthesia. The horses were euthanatized approximately 48 hours later, and the jugular veins were removed for histologic examination. Adherent thrombus material was observed in all veins exposed to 10% guaifenesin and in one vein exposed to 5% guaifenesin. No evidence of thrombus was observed in four veins infused with 5% guaifenesin or in those infused with saline solution. These findings are of particular significance with horses at increased risk for thrombosis or thrombophlebitis.

Forty-eight hours after general anaesthesia was induced by glycerol guaiacolate and thiopentone sodium in 10 horses, the jugular veins were dissected out at post-mortem and examined visually and histologically. All veins showed a marked thrombophlebitis involving the media and intima at the site of injection. The influence of catheter composition, catheter placement and chemical composition on the occurrence of the thrombophlebitis is discussed. It is concluded that the thrombophlebitis was chemically induced.

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.

A double-blind placebo-controlled crossover study was done to evaluate the efficacy of an oral decongestant preparation in the treatment of rhinitis. The preparation consisted of 5 mg of phenylephrine hydrochloride, 45 mg of phenylpropanolamine hydrochloride, and 200 mg of guaifenesin (Rymed). Subjects were selected for participation in the study on the basis of history, physical examination, and immediate hypersensitivity skin testing. Fourteen of 20 subjects (P less than .05) observed a reduction in the severity of nasal symptoms while taking the drug. The mean symptom score of the 20 subjects while taking the drug was 31.344 and while taking placebo, 42.979. This is a statistically significant difference (P = .009717). Side effects were minimal. We concluded that the oral decongestant preparation used in this study is effective in controlling symptoms of rhinitis.

The purpose of this survey was to identify complications occurring in horses with colic during anaesthesia and recovery from anaesthesia; and to determine any relationships between these complications and drugs used for induction or maintenance of anaesthesia. Two hundred and thirty nine horses were anaesthetised on a total of 250 occasions for colic surgery between January 1985 and May 1987. Of these, 189 recovered from 200 anaesthetic episodes. Most horses received xylazine and guaifenesin with either thiobarbiturate (68 per cent) or ketamine (24 per cent) and anaesthesia was maintained with either halothane (51 per cent), isoflurane (43 per cent), or first halothane then isoflurane (6 per cent). Sixty nine per cent also received an opioid. Hypotension or tachycardia were recorded in 15 and 13 per cent of anaesthesias, respectively. Arterial PO2 was less than 13.3 kPa in 17 per cent of 175 anaesthesias. None of these complications was associated with a specific anaesthetic agent. Hypertension was recorded in 11.5 per cent of anaesthesias and occurred more frequently during isoflurane anaesthesia (P < 0.05). The mean duration of anaesthesia was 126 mins (range, 50-270 mins), and was not different for horses receiving thiobarbiturate or ketamine, halothane or isoflurane. The time taken to stand after anaesthesia recorded on 149 occasions and was 63 +/- 24 mins (range, 15-135 mins). This was not different for the different anaesthetic agents. Horses that were excited or had difficulty standing up during recovery had a significantly longer duration of anaesthesia (165 +/- 51 mins) (P < 0.05) but no specific anaesthetic agent was involved. Of the 189 horses, 148 (75 per cent) survived and were discharged from the hospital. Horses that did not survive had a significantly increased prevalence of anaesthetic complications, and longer durations of anaesthesia.

Eight bulls and steers (research animals) and 18 bulls (surgical patients) were anesthetized with guaifenesin and thiopental or thiamylal and for 90 minutes with halothane. Arterial blood pressure and heart rate were recorded in all animals. Cardiac output, plasma glucose and lactate concentrations, PCV, plasma proteins and plasma thromboxane B2 values were determined before (control) and every 15 minutes during anesthesia in the research animals. Plasma catecholamine concentrations were measured in 3 of the research animals and 3 of the surgical patients. Arterial pressure, heart rate, and plasma thromboxane B2 and catecholamine concentrations were also measured immediately after the trachea was intubated. All animals, except one, were hypertensive during anesthesia. Heart rate during anesthesia was significantly increased, compared with control measurements, and cardiac output was decreased. Plasma glucose and lactate values significantly increased when the animals were restrained on their sides. Plasma glucose concentrations remained increased during anesthesia, but lactate decreased. Packed cell volume and plasma proteins were unchanged by the induction of anesthesia. Plasma norepinephrine concentration was unchanged during anesthesia, and epinephrine concentration was decreased. Endotracheal intubation caused a transient significant increase in arterial pressure, heart rate, and thromboxane B2 and a nonsignificant increase in norepinephrine.